Provider Demographics
NPI:1225315948
Name:VERONICA DEYESO MD PC
Entity Type:Organization
Organization Name:VERONICA DEYESO MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:O
Authorized Official - Last Name:DEYESO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-443-9082
Mailing Address - Street 1:261 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-6810
Mailing Address - Country:US
Mailing Address - Phone:413-443-9082
Mailing Address - Fax:413-443-0361
Practice Address - Street 1:261 SOUTH ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-6810
Practice Address - Country:US
Practice Address - Phone:413-443-9082
Practice Address - Fax:413-443-0361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty