Healthcare Provider Details

I. General information

NPI: 1033328786
Provider Name (Legal Business Name): BERKSHIRE ALLERGY CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 06/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

369 SOUTH ST
PITTSFIELD MA
01201-6865
US

IV. Provider business mailing address

369 SOUTH ST
PITTSFIELD MA
01201-6865
US

V. Phone/Fax

Practice location:
  • Phone: 413-443-4826
  • Fax: 413-443-4488
Mailing address:
  • Phone: 413-443-4826
  • Fax: 413-443-4488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number189926
License Number StateMA

VIII. Authorized Official

Name: DR. THOMAS B. EDWARDS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 413-443-4826