Healthcare Provider Details

I. General information

NPI: 1750342523
Provider Name (Legal Business Name): LOUIS V. PACILIO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 LOCUST ST
NORTHAMPTON MA
01060-2052
US

IV. Provider business mailing address

291 MOODY ST
LUDLOW MA
01056-1246
US

V. Phone/Fax

Practice location:
  • Phone: 413-582-2493
  • Fax: 413-582-2518
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 Number50806
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: