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Organization

PIONEER VALLEY NUTRITION, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. POLLY ANN OBREMSKI RD, LDN, CDE (OWNER)
(413) 584-2200
Entity
Organization

Contact information

Practice address
39 CARLON DR, NORTHAMPTON, MA 01060-2374
(413) 584-2200
(413) 584-2255
Mailing address
39 CARLON DR, NORTHAMPTON, MA 01060-2374
(413) 584-2200
(413) 584-2255

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2232
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11326384
CAQH NUMBER
MA
01
35122
HEALTH NEW ENGLAND
MA
01
4609501
CIGNA NUMBER
MA
01
AA59459
HARVARD PILGRIM
MA
01
LG0035
BCBS GROUP NUMBER
MA
01
MT0840
MEDICARE
MA
Enumeration date
06/01/2006
Last updated
05/22/2009
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