Basic Information
| Provider Information | |||||||||
| NPI: | 1134650542 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PIONEER NEUROLOGY AND SLEEP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 299 CAREW ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011042301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137361500 | ||||||||
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| Address1: | 299 CAREW ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011042301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137361500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2017 | ||||||||
| LastUpdateDate: | 03/28/2017 | ||||||||
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| AuthorizedOfficialLastName: | DUGRE | ||||||||
| AuthorizedOfficialFirstName: | MICHELLE | ||||||||
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| AuthorizedOfficialTitleorPosition: | BILLING | ||||||||
| AuthorizedOfficialTelephone: | 4135251611 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 208931 | MA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.