Basic Information
| Provider Information | |||||||||
| NPI: | 1164436093 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHILD AND FAMILY SERVICE OF PIONEER VALLEY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 925 S EAST ST | ||||||||
| Address2: | |||||||||
| City: | AMHERST | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010023051 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4132539633 | ||||||||
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| Practice Location | |||||||||
| Address1: | 367 PINE ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011051930 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137371426 | ||||||||
| FaxNumber: | 4137399988 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | STEIN | ||||||||
| AuthorizedOfficialFirstName: | MYRON | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4137371426 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | 37760 | MA | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.