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General NPI Number Information
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NPI Number | 1447332762
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Entity Type | Organization
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Legal Business Name | GREYLOCK RADIOLOGY ASSOCIATES PC
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 08/12/2014
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Provider Practice Location Address
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Address Line | 71 HOSPITAL AVE
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City | NORTH ADAMS
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State | MA
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Zip | 01247-2504
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Country | US
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Telephone | 413-664-5279
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Fax | 413-589-7554
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Provider Business Mailing Address
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Address Line | 291 MOODY ST
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City | LUDLOW
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State | MA
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Zip | 01056-1246
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Country | US
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Telephone | 800-688-6663
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Fax | 413-589-7554
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY BATH
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Credential | MD
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Telephone | 413-664-5279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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