Provider Demographics
NPI:1477562916
Name:BERKSHIRE THERAPY WORKS, INC.
Entity type:Organization
Organization Name:BERKSHIRE THERAPY WORKS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, PRACTICE OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEWIS-KELLOGG
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:413-442-7337
Mailing Address - Street 1:279 DALTON AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-3540
Mailing Address - Country:US
Mailing Address - Phone:413-442-7337
Mailing Address - Fax:413-447-3882
Practice Address - Street 1:279 DALTON AVE
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-3540
Practice Address - Country:US
Practice Address - Phone:413-442-7337
Practice Address - Fax:413-447-3882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11063225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAOG0013OtherBLUE CROSS - OT
MASG0015OtherBLUE CROSS - SPEECH
MAY61317OtherBLUE CROSS - PT
MA694513OtherTUFTS
MABE PT0262Medicare ID - Type UnspecifiedGROUP ID