| Primary Care Of The Brookfieldspllc | |
|
82 Wendell Ave Ste 100 Pittsfield MA 01201-7066 | |
| (774) 227-3556 | |
| (508) 213-9008 |
| Full Name | Primary Care Of The Brookfieldspllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 82 Wendell Ave Ste 100, Pittsfield, Massachusetts |
| Authorized Official Name and Position | Michelle Dedon (OWNER AND NURSE PRACTITIONER) |
| Authorized Official Contact | 7742273556 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Of The Brookfieldspllc 130 Main St # 5011 Spencer MA 01562-2141 Ph: (774) 227-3556 | Primary Care Of The Brookfieldspllc 82 Wendell Ave Ste 100 Pittsfield MA 01201-7066 Ph: (774) 227-3556 |
| NPI Number | 1750135216 |
|---|---|
| Provider Enumeration Date | 04/12/2024 |
| Last Update Date | 04/12/2024 |
| Medicare PECOS PAC ID | 3274975875 |
|---|---|
| Medicare Enrollment ID | O20240529000423 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750135216 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Michelle M Dedon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669960274 PECOS PAC ID: 0941559108 Enrollment ID: I20180821002304 |
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