Provider Demographics
NPI:1952517013
Name:PLEASANT VALLEY INTERNISTS P.C.
Entity Type:Organization
Organization Name:PLEASANT VALLEY INTERNISTS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PERIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:THAVASEELAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-689-0869
Mailing Address - Street 1:60 EAST ST
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-4500
Mailing Address - Country:US
Mailing Address - Phone:978-689-0869
Mailing Address - Fax:978-689-3096
Practice Address - Street 1:60 EAST ST
Practice Address - Street 2:SUITE 1400
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-4500
Practice Address - Country:US
Practice Address - Phone:978-689-0869
Practice Address - Fax:978-689-3096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA55639207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1861409989OtherNPI NBR
MA1417959776OtherNPI SALAH ABASS
MA2085780Medicaid
MA0171557Medicaid
MAA53991Medicare UPIN
MAI05739Medicare UPIN
MA0171557Medicaid
MAD02066Medicare ID - Type Unspecified