Provider Demographics
NPI:1497862759
Name:PREGOZEN, NEIL (LIC AC)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:
Last Name:PREGOZEN
Suffix:
Gender:M
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 POMEROY LN
Mailing Address - Street 2:UNIT #5
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-2941
Mailing Address - Country:US
Mailing Address - Phone:413-230-9609
Mailing Address - Fax:
Practice Address - Street 1:34 POMEROY LN
Practice Address - Street 2:UNIT #5
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2941
Practice Address - Country:US
Practice Address - Phone:413-230-9609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA224446171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist