Provider Demographics
NPI:1669434502
Name:VALLEY NEUROLOGICAL SURGERY PC
Entity type:Organization
Organization Name:VALLEY NEUROLOGICAL SURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:KAYE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-827-8800
Mailing Address - Street 1:PO BOX 789
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:MA
Mailing Address - Zip Code:01056-0789
Mailing Address - Country:US
Mailing Address - Phone:413-509-1000
Mailing Address - Fax:413-509-1003
Practice Address - Street 1:300 STAFFORD ST
Practice Address - Street 2:SUITE 264
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-3581
Practice Address - Country:US
Practice Address - Phone:413-827-8800
Practice Address - Fax:413-827-8811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA71211174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3053245Medicaid
MAJ08850OtherBLUE SHIELD OF MA
MA751015OtherTUFTS
MA102900800OtherUS DEPT OF LABOR
MA122410OtherAETNA US HEALTHCARE
MA98128001OtherNETWORK HEALTH
MA712110OtherCONNECTICARE
MA088468683OtherTRICARE
MA102900800OtherUS DEPT OF LABOR
MAA63987Medicare UPIN
MAS31461Medicare UPIN
MAAP001702Medicare PIN