Provider Demographics
NPI:1033521000
Name:SANSKY, MICHELLE LAUREN (DO)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LAUREN
Last Name:SANSKY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 SUMMER ST STE 301
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4652
Mailing Address - Country:US
Mailing Address - Phone:413-442-0085
Mailing Address - Fax:413-464-9143
Practice Address - Street 1:42 SUMMER ST STE 301
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4652
Practice Address - Country:US
Practice Address - Phone:413-442-0085
Practice Address - Fax:413-464-9143
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA270832207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program