Healthcare Provider Details

I. General information

NPI: 1447332762
Provider Name (Legal Business Name): GREYLOCK RADIOLOGY ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 08/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 HOSPITAL AVE
NORTH ADAMS MA
01247-2504
US

IV. Provider business mailing address

291 MOODY ST
LUDLOW MA
01056-1246
US

V. Phone/Fax

Practice location:
  • Phone: 413-664-5279
  • Fax: 413-589-7554
Mailing address:
  • Phone: 800-688-6663
  • Fax: 413-589-7554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY BATH
Title or Position: PRESIDENT
Credential: MD
Phone: 413-664-5279