Provider Demographics
NPI:1821161795
Name:BERKSHIRE CLINICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:BERKSHIRE CLINICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MALATHI
Authorized Official - Middle Name:
Authorized Official - Last Name:YELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-442-8324
Mailing Address - Street 1:20 MEADOW RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-5762
Mailing Address - Country:US
Mailing Address - Phone:413-329-4437
Mailing Address - Fax:
Practice Address - Street 1:188 EAST ST STE 103
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-5362
Practice Address - Country:US
Practice Address - Phone:413-442-8324
Practice Address - Fax:413-442-8334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA215563207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA661784OtherTUFTS HEALTH PLAN
MABCBSOtherM19229