Provider Demographics
NPI:1528011160
Name:BRASSEUR, CURTIS J (DO)
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:J
Last Name:BRASSEUR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1243
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01202-1243
Mailing Address - Country:US
Mailing Address - Phone:413-447-2453
Mailing Address - Fax:413-447-2451
Practice Address - Street 1:725 NORTH ST
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4132
Practice Address - Country:US
Practice Address - Phone:413-447-2453
Practice Address - Fax:413-447-2451
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2165592085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Not Answered2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2000890Medicaid
NY02410557Medicaid
MA2000890Medicaid
A79078Medicare UPIN