Provider Demographics
NPI:1043405269
Name:DENNIS R. PRONOWICZ,P.T.,INC.
Entity Type:Organization
Organization Name:DENNIS R. PRONOWICZ,P.T.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:PRONOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:413-532-9913
Mailing Address - Street 1:138 COLLEGE ST
Mailing Address - Street 2:STE.3
Mailing Address - City:SOUTH HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01075-1415
Mailing Address - Country:US
Mailing Address - Phone:413-532-9913
Mailing Address - Fax:413-532-9054
Practice Address - Street 1:138 COLLEGE ST
Practice Address - Street 2:STE.3
Practice Address - City:SOUTH HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01075-1415
Practice Address - Country:US
Practice Address - Phone:413-532-9913
Practice Address - Fax:413-532-9054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1886261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY61070OtherBLUE CROSS & BLUE SHIELD