Organization
PIONEER VALLEY RADIATION ONCOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN ACKER M.D. (AUTHORIZED OFFICIAL)
(413) 794-9338
Entity
Organization
Contact information
Practice address
3350 MAIN ST, SPRINGFIELD, MA 01107-1112
(413) 794-9175
(413) 794-5153
Mailing address
PO BOX 4110, DEPT 1410, WOBURN, MA 01888-4110
(413) 794-9338
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
74050
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9783679
—
MA
01
—
M16963
BLUE CROSS BLUE SHIELD
MA
01
—
M20534
MEDICARE PTAN
MA
Enumeration date
07/08/2006
Last updated
09/16/2015
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