Healthcare Provider Details

I. General information

NPI: 1275373904
Provider Name (Legal Business Name): PIONEERS CONSULTANTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2024
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 W THOMPSON AVE
SPRINGFIELD PA
19064-2111
US

IV. Provider business mailing address

164 W THOMPSON AVE
SPRINGFIELD PA
19064-2111
US

V. Phone/Fax

Practice location:
  • Phone: 504-261-6395
  • Fax:
Mailing address:
  • Phone: 504-261-6395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P0301X
TaxonomyBrain Injury Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BABATUNDE BABALOLA
Title or Position: PHYSICIAN/MEDICAL DIRECTOR
Credential: MD
Phone: 504-261-6395