Individual
BENJAMIN ALAN FONTAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
777 NORTH ST, PITTSFIELD, MA 01201-4147
(413) 499-8551
Mailing address
777 NORTH STREET, PITTSIELD, MA 01021
(413) 499-8551
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA5401
MA
Other
Enumeration date
07/02/2015
Last updated
04/06/2022
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