Healthcare Provider Details

I. General information

NPI: 1174460703
Provider Name (Legal Business Name): NEW ENGLAND NEUROVASCULAR ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 WENDELL AVE STE 100
PITTSFIELD MA
01201-7066
US

IV. Provider business mailing address

82 WENDELL AVE STE 100
PITTSFIELD MA
01201-7066
US

V. Phone/Fax

Practice location:
  • Phone: 617-546-1976
  • Fax:
Mailing address:
  • Phone: 617-546-1976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: AJIT SINGH PURI
Title or Position: PRESIDENT
Credential:
Phone: 617-543-5882