Organization
BERKSHIRE COLON & RECTAL SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCELLA W. BRADWAY M.D. (OWNER)
(413) 447-2859
Entity
Organization
Contact information
Practice address
777 NORTH ST, SUITE 605, PITTSFIELD, MA 01201-4147
(413) 447-2859
(413) 346-6703
Mailing address
93 RIDGE AVE, PITTSFIELD, MA 01201-4147
(413) 447-2859
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D04850
RAILROAD MEDICARE
MA
Enumeration date
07/21/2008
Last updated
06/19/2013
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