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General NPI Number Information
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NPI Number | 1699969329
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Entity Type | Organization
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Legal Business Name | BERKSHIRE MEDICINE INC.
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Dates
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Enumeration Date | 09/06/2007
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Last Update Date | 09/06/2007
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Provider Practice Location Address
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Address Line | 163 SOUTH ST
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City | PITTSFIELD
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State | MA
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Zip | 01201-6988
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Country | US
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Telephone | 413-442-3309
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Fax | 413-358-9014
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Provider Business Mailing Address
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Address Line | 163 SOUTH ST
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City | PITTSFIELD
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State | MA
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Zip | 01201-6988
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Country | US
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Telephone | 413-442-3309
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Fax | 413-358-9014
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BARRY LOBOVITS
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Credential | MD
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Telephone | 413-442-3309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 39562
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License Number State | MA
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