Provider Demographics
NPI:1902542590
Name:NIGROSH, OLIVER MAX (MSPO, CPO)
Entity Type:Individual
Prefix:MR
First Name:OLIVER
Middle Name:MAX
Last Name:NIGROSH
Suffix:
Gender:M
Credentials:MSPO, CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 BEARSDEN RD
Mailing Address - Street 2:
Mailing Address - City:ATHOL
Mailing Address - State:MA
Mailing Address - Zip Code:01331-3439
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:29 FORGET RD
Practice Address - Street 2:
Practice Address - City:HAWLEY
Practice Address - State:MA
Practice Address - Zip Code:01339-9735
Practice Address - Country:US
Practice Address - Phone:413-695-1606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-07
Last Update Date:2022-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier