Provider Demographics
NPI:1346282621
Name:PIONEER SPINE AND SPORTS PHYSICIANS PC
Entity Type:Organization
Organization Name:PIONEER SPINE AND SPORTS PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:N
Authorized Official - Last Name:PAASCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-785-1153
Mailing Address - Street 1:271 PARK ST
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-3311
Mailing Address - Country:US
Mailing Address - Phone:413-785-1153
Mailing Address - Fax:413-781-4951
Practice Address - Street 1:271 PARK ST
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-3311
Practice Address - Country:US
Practice Address - Phone:413-785-1153
Practice Address - Fax:413-781-4951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9762868Medicaid
MAM15170OtherBCBS
MA972640OtherNETWORK HEALTH
MA9762868Medicaid