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General NPI Number Information
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NPI Number | 1750135216
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE OF THE BROOKFIELDSPLLC
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Dates
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Enumeration Date | 04/12/2024
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 82 WENDELL AVE STE 100
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City | PITTSFIELD
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State | MA
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Zip | 01201-7066
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Country | US
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Telephone | 774-227-3556
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Fax | 508-213-9008
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Provider Business Mailing Address
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Address Line | 221 E MAIN ST # 5011
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City | EAST BROOKFIELD
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State | MA
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Zip | 01515-1639
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Country | US
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Telephone | 774-227-3556
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Fax | 508-213-9008
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Authorized Official
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Title or Position | OWNER AND NURSE PRACTITIONER
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Name | MICHELLE DEDON
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Credential | DNP
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Telephone | 774-227-3556
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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 |
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License Number State |
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