Provider Demographics
NPI:1750342523
Name:PACILIO, LOUIS V (MD)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:V
Last Name:PACILIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:291 MOODY ST
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:MA
Mailing Address - Zip Code:01056-1246
Mailing Address - Country:US
Mailing Address - Phone:800-688-6663
Mailing Address - Fax:413-589-7554
Practice Address - Street 1:30 LOCUST ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2052
Practice Address - Country:US
Practice Address - Phone:413-582-2493
Practice Address - Fax:413-582-2518
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA508062085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000006712OtherBMC
MA3195811OtherCIGNA
MA6164889Medicaid
MA2376613OtherAETNA
MA754053OtherTUFTS
MAJ01156OtherBCBSMA
MA240478OtherHARVARD PILGRIM
MA240478OtherHARVARD PILGRIM
MA6164889Medicaid