Provider Demographics
NPI:1003030867
Name:CULLINEY, BRIAN (DC)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:CULLINEY
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:PO BOX 517
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM HEIGHTS
Mailing Address - State:MA
Mailing Address - Zip Code:02494-0011
Mailing Address - Country:US
Mailing Address - Phone:781-559-8700
Mailing Address - Fax:781-559-8778
Practice Address - Street 1:410 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-1341
Practice Address - Country:US
Practice Address - Phone:978-458-6620
Practice Address - Fax:978-458-6671
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1833111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY36311OtherBCBS
MA407328OtherTUFTS
MA350324OtherHARVARD PILGRIM HEALTHCAR
MAY36311OtherBCBS