MEDICARE: DR. ALAN GRAY KULBERG MD

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	57098	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

General Provider Information

NPI Number	:	1053360552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN GRAY KULBERG MD

Provider Business Mailing Address
First Line	:	777 NORTH ST STE 305
Second Line	:	BERKSHIRE PEDIATRIC ASSOCIATES PC
City	:	PITTSFIELD
State	:	MA
Zip	:	01201-4172
Country	:	US
Telephone Number	:	413-499-8535
Fax Number	:	413-499-8535

Provider Business Practice Location Address
First Line	:	777 NORTH ST STE 305
Second Line	:	BERKSHIRE PEDIATRIC ASSOCIATES PC
City	:	PITTSFIELD
State	:	MA
Zip	:	01201-4172
Country	:	US
Telephone Number	:	413-499-8535
Fax Number	:	413-499-8535

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	01/31/2014

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