Provider Demographics
NPI:1710993134
Name:BERKSHIRE EYE CENTER, P.C.
Entity Type:Organization
Organization Name:BERKSHIRE EYE CENTER, P.C.
Other - Org Name:DAPSON OPTICAL DIVISION
Other - Org Type:Other Name
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DAPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-448-8559
Mailing Address - Street 1:740 WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-7463
Mailing Address - Country:US
Mailing Address - Phone:413-448-8559
Mailing Address - Fax:413-499-9275
Practice Address - Street 1:740 WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-7463
Practice Address - Country:US
Practice Address - Phone:413-448-8559
Practice Address - Fax:413-499-9275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9774017Medicaid
MA9774017Medicaid
MAM16029Medicare PIN