Provider Demographics
NPI:1003090770
Name:GINAMARIEHANLON,D.C.,P.C.
Entity Type:Organization
Organization Name:GINAMARIEHANLON,D.C.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HANLON-CAVICCHI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-746-0550
Mailing Address - Street 1:145 COURT ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-3807
Mailing Address - Country:US
Mailing Address - Phone:508-746-0550
Mailing Address - Fax:508-746-0072
Practice Address - Street 1:145 COURT ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-3807
Practice Address - Country:US
Practice Address - Phone:508-746-0550
Practice Address - Fax:508-746-0072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2009-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1922111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1873815OtherCIGNA
MA351403OtherHARVARD PILGRIM
MA461123OtherTUFTS
MAY39712OtherBCBS
MA642151OtherACN
MA461123OtherTUFTS
MA642151OtherACN
MA=========OtherAETNA
MA=========OtherPHCS