Individual
DR. LARRY J PELLISH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
777 NORTH ST, SUITE 203, PITTSFIELD, MA 01201-4147
(413) 499-8590
(413) 499-6410
Mailing address
777 NORTH ST, SUITE 203, PITTSFIELD, MA 01201-4147
(413) 499-8590
(413) 499-6410
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
40795
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00536205
—
NY
01
—
040795
TUFTS HEALTHPLAN
MA
01
—
10034390
CDPHP
NY
01
—
15329
HEALTH NEW ENGLAND
MA
05
—
2056186
—
MA
01
—
365677
MVP
NY
01
—
A66253
HARVARD PILGRIM HEALTHCAR
MA
01
—
I22244
BCBSMA
MA
Enumeration date
01/28/2006
Last updated
07/08/2007
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