Provider Demographics
NPI:1063446615
Name:HOLISTIC FAMILY PRACTICE, INC.
Entity Type:Organization
Organization Name:HOLISTIC FAMILY PRACTICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:MARCH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:978-465-9770
Mailing Address - Street 1:65 NEWBURYPORT TPKE
Mailing Address - Street 2:
Mailing Address - City:NEWBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01951-1113
Mailing Address - Country:US
Mailing Address - Phone:978-465-9770
Mailing Address - Fax:978-465-9004
Practice Address - Street 1:65 NEWBURYPORT TPKE
Practice Address - Street 2:
Practice Address - City:NEWBURY
Practice Address - State:MA
Practice Address - Zip Code:01951-1113
Practice Address - Country:US
Practice Address - Phone:978-465-9770
Practice Address - Fax:978-465-9004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM15679OtherBCBS GROUP ID NUMBER
MA34866OtherFALLON GROUP ID NUMBER
MA723361OtherTUFTS HEALTH GROUP ID #
MA9769331Medicaid
MAM15679Medicare ID - Type UnspecifiedGROUP ID NUMBER