Provider Demographics
NPI:1194890160
Name:PIAZZA, RONALD JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:JOSEPH
Last Name:PIAZZA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-1503
Mailing Address - Country:US
Mailing Address - Phone:413-442-5022
Mailing Address - Fax:413-499-1946
Practice Address - Street 1:835 NORTH ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-1503
Practice Address - Country:US
Practice Address - Phone:413-442-5022
Practice Address - Fax:413-499-1946
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1223111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1608312Medicaid