Provider Demographics
NPI:1619025061
Name:PIONEER VALLEY OPHTHALMIC CONSULTANTS, P.C.
Entity Type:Organization
Organization Name:PIONEER VALLEY OPHTHALMIC CONSULTANTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:FRANGIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-775-9900
Mailing Address - Street 1:489 BERNARDSTON RD
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-1234
Mailing Address - Country:US
Mailing Address - Phone:413-775-9900
Mailing Address - Fax:413-775-9922
Practice Address - Street 1:489 BERNARDSTON RD
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-1234
Practice Address - Country:US
Practice Address - Phone:413-775-9900
Practice Address - Fax:413-775-9922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59951174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9083555Medicaid
MA9083555Medicaid