Provider Demographics
NPI:1851601231
Name:BEHZAD PARHIZGAR MD
Entity Type:Organization
Organization Name:BEHZAD PARHIZGAR MD
Other - Org Name:BERKSHIRE DERMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PATIENT ACCOUNT MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JODY
Authorized Official - Middle Name:
Authorized Official - Last Name:UNDERHILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-443-1439
Mailing Address - Street 1:195 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-6831
Mailing Address - Country:US
Mailing Address - Phone:413-443-1439
Mailing Address - Fax:413-443-1164
Practice Address - Street 1:195 SOUTH ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-6831
Practice Address - Country:US
Practice Address - Phone:413-443-1439
Practice Address - Fax:413-443-1164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-19
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA54766174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6194893Medicaid
MA15218OtherHEALTH NEW ENGLAND
MA722372OtherTUFTS HEALTH PLAN
MAJ04512OtherMEDICARE PTAN
MAJ04512OtherBCBS OF MA
MAJ04512OtherMEDICARE PTAN