MEDICARE: MACONY, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician		MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023027810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MACONY, PC

Provider Business Mailing Address
First Line	:	100 MAPLE AVE STE 1
Second Line	:
City	:	GREAT BARRINGTON
State	:	MA
Zip	:	01230-1965
Country	:	US
Telephone Number	:	413-528-4047
Fax Number	:	413-528-3407

Provider Business Practice Location Address
First Line	:	100 MAPLE AVE STE 1
Second Line	:
City	:	GREAT BARRINGTON
State	:	MA
Zip	:	01230-1965
Country	:	US
Telephone Number	:	413-528-4047
Fax Number	:	413-528-3407

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. LAURIE W VIEBROCK
Credential	:
Telephone Number	:	413-528-4047

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	08/22/2020

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Directions to “MACONY, PC ” Practice Location

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