Bradley Pisko, LPN

Individual provider Active NPI Licensed Practical Nurse · Conway, MA

NPI 1235544917 · NPPES record last updated Jun 21, 2014

Key facts

NPI
1235544917
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
LN90848 (MA)
Practice address
199 Hoosac Rd
Conway, MA 01341-9794
Phone
(413) 441-2843
NPI assigned
Jun 21, 2014
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LN90848MAMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LN90848 MA Yes

Addresses

Primary practice location

199 Hoosac Rd
Conway, MA 01341-9794

Mailing address

199 Hoosac Rd
Conway, MA 01341-9794
Phone (413) 441-2843

Other providers in Conway, MA

All providers in Conway, MA · Licensed Practical Nurse in Massachusetts

Sources for this page

Verify at the official NPI Registry.