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General NPI Number Information
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NPI Number | 1285673186
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Entity Type | Organization
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Legal Business Name | BERKSHIRE COSMETIC & RECONSTRUCTIVE SURGERY CENTER INC.
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 01/15/2013
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Provider Practice Location Address
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Address Line | 426 SOUTH ST
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City | PITTSFIELD
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State | MA
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Zip | 01201-8228
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Country | US
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Telephone | 413-496-9272
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Fax | 413-442-6990
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Provider Business Mailing Address
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Address Line | 426 SOUTH ST
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City | PITTSFIELD
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State | MA
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Zip | 01201-8228
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Country | US
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Telephone | 413-496-9272
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Fax | 413-442-6990
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | BASIL M. MICHAELS
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Credential | M.D.
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Telephone | 413-496-9272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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