Provider Demographics
NPI:1871655662
Name:PAVILION HAND SURGEONS, INC.
Entity Type:Organization
Organization Name:PAVILION HAND SURGEONS, INC.
Other - Org Name:THE HAND CENTER OF WESTERN MASSACHUSETTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:C
Authorized Official - Last Name:WINT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-733-2204
Mailing Address - Street 1:3550 MAIN ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1089
Mailing Address - Country:US
Mailing Address - Phone:413-733-2204
Mailing Address - Fax:413-734-0587
Practice Address - Street 1:3550 MAIN ST
Practice Address - Street 2:SUITE 204
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1089
Practice Address - Country:US
Practice Address - Phone:413-733-2204
Practice Address - Fax:413-734-0587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0151750001OtherMEDICARE DME GROUP NUMBER
MA0151750001OtherMEDICARE DME GROUP NUMBER