Provider Demographics
NPI:1346427713
Name:PIONEER SPINE AND SPORTS PHYSICIANS, PC
Entity Type:Organization
Organization Name:PIONEER SPINE AND SPORTS PHYSICIANS, PC
Other - Org Name:PIONEER THERAPY SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
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:413-785-5777
Mailing Address - Fax:413-781-8552
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:413-785-5777
Practice Address - Fax:413-781-8552
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PIONEER SPINE AND SPORTS PHYSICIANS,PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-28
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
687653OtherTUFTS
MAY61230OtherBLUE CROSS BLUE SHIELD
MAPT0201Medicare PIN