Healthcare Provider Details

I. General information

NPI: 1053338996
Provider Name (Legal Business Name): PIONEER VALLEY IMAGING, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 W SILVER ST NOBLE HOSPITAL
WESTFIELD MA
01085-3628
US

IV. Provider business mailing address

291 MOODY ST
LUDLOW MA
01056-1246
US

V. Phone/Fax

Practice location:
  • Phone: 413-572-5055
  • Fax: 413-572-5088
Mailing address:
  • Phone: 413-589-0195
  • Fax: 413-589-7554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number38313
License Number StateMA

VIII. Authorized Official

Name: DR. HOWARD RAYMOND
Title or Position: PRESIDENT
Credential: M.D.
Phone: 413-572-5055