Basic Information
| Provider Information | |||||||||
| NPI: | 1912920737 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VALIGORSKY | ||||||||
| FirstName: | JON | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 93 TOR CT | ||||||||
| Address2: | |||||||||
| City: | PITTSFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 012013052 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4134429143 | ||||||||
| FaxNumber: | 4133957622 | ||||||||
| Practice Location | |||||||||
| Address1: | 725 NORTH STREET | ||||||||
| Address2: | BERKSHIRE MEDICAL CENTER | ||||||||
| City: | PITTSFIELSD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 012010352 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4134472569 | ||||||||
| FaxNumber: | 4133957622 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | 39873 | MA | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
ID Information
| ID | Type | State | Issuer | Description | 2045419 | 05 | MA | MEDICAID |