Provider Demographics
NPI:1194705459
Name:PITTSFIELD CARDIOLOGY, PC
Entity type:Organization
Organization Name:PITTSFIELD CARDIOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:KUSICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-442-4001
Mailing Address - Street 1:PO BOX 2448
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01202-2448
Mailing Address - Country:US
Mailing Address - Phone:413-442-4001
Mailing Address - Fax:413-442-8856
Practice Address - Street 1:188 EAST STREET SUITE 102
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4102
Practice Address - Country:US
Practice Address - Phone:413-442-4001
Practice Address - Fax:413-442-8856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-20
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAE61760OtherHARVARD PILGRIM HC
MAM17598OtherBCBSMA
MA9701681Medicaid
MA682800OtherTUFTS
7568OtherCDPHP
7568OtherCDPHP