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General NPI Number Information
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NPI Number | 1437427556
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Entity Type | Organization
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Legal Business Name | PIONEER VALLEY LUNG ASSOCIATES INC
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Dates
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Enumeration Date | 12/03/2011
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Last Update Date | 09/12/2013
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Provider Practice Location Address
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Address Line | 10 HOSPITAL DR SUITE #206
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City | HOLYOKE
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State | MA
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Zip | 01040-6643
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Country | US
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Telephone | 361-813-8771
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Fax |
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Provider Business Mailing Address
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Address Line | 38 ERICKA CIR
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City | EAST LONGMEADOW
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State | MA
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Zip | 01028-1658
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Country | US
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Telephone | 361-813-8771
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SIVA P SIVAKUMAR
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Credential | M.D.
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Telephone | 361-813-8771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 247647
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 247647
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License Number State | MA
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