Provider Demographics
NPI:1437427556
Name:PIONEER VALLEY LUNG ASSOCIATES INC
Entity Type:Organization
Organization Name:PIONEER VALLEY LUNG ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SIVA
Authorized Official - Middle Name:P
Authorized Official - Last Name:SIVAKUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-813-8771
Mailing Address - Street 1:38 ERICKA CIR
Mailing Address - Street 2:
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-1658
Mailing Address - Country:US
Mailing Address - Phone:361-813-8771
Mailing Address - Fax:
Practice Address - Street 1:10 HOSPITAL DR
Practice Address - Street 2:SUITE #206
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-6643
Practice Address - Country:US
Practice Address - Phone:361-813-8771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-03
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA247647207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty