Provider Demographics
NPI:1114020211
Name:PIONEER VALLEY DERMATOLOGY, PC
Entity Type:Organization
Organization Name:PIONEER VALLEY DERMATOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:DIPILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-549-7400
Mailing Address - Street 1:29 COTTAGE ST STE B
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-2178
Mailing Address - Country:US
Mailing Address - Phone:413-549-7400
Mailing Address - Fax:413-549-7402
Practice Address - Street 1:29 COTTAGE ST STE B
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2178
Practice Address - Country:US
Practice Address - Phone:413-549-7400
Practice Address - Fax:413-549-7402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Not Answered363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA10793OtherPHCS
MAM17917OtherBCBS MA
MA688686OtherTUFTS
MA6136OtherCOMMONWEALTH IDEM.
MAM17917OtherBCBS MA