Healthcare Provider Details

I. General information

NPI: 1619025061
Provider Name (Legal Business Name): PIONEER VALLEY OPHTHALMIC CONSULTANTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 01/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

489 BERNARDSTON RD
GREENFIELD MA
01301-1234
US

IV. Provider business mailing address

489 BERNARDSTON RD
GREENFIELD MA
01301-1234
US

V. Phone/Fax

Practice location:
  • Phone: 413-775-9900
  • Fax: 413-775-9922
Mailing address:
  • Phone: 413-775-9900
  • Fax: 413-775-9922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number59951
License Number StateMA

VIII. Authorized Official

Name: DR. JOHN P FRANGIE
Title or Position: PRESIDENT
Credential: MD
Phone: 413-775-9900