Provider Demographics
NPI:1235389883
Name:NORTHAMPTON RADIATION ONCOLOGY, LLC
Entity Type:Organization
Organization Name:NORTHAMPTON RADIATION ONCOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:E
Authorized Official - Last Name:BORNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-582-2107
Mailing Address - Street 1:30 LOCUST STREET, COOLEY DICKINSON HOSPITAL
Mailing Address - Street 2:NORTHAMPTON RADIATION ONCOLOGY, LLC
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060
Mailing Address - Country:US
Mailing Address - Phone:413-582-2107
Mailing Address - Fax:413-582-2963
Practice Address - Street 1:30 LOCUST STREET, COOLEY DICKINSON HOSPITAL
Practice Address - Street 2:NORTHAMPTON RADIATION ONCOLOGY, LLC
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060
Practice Address - Country:US
Practice Address - Phone:413-582-2107
Practice Address - Fax:413-582-2963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-19
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA773722085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty