Provider Demographics
NPI:1073678827
Name:EILEEN GERALYN CEJKA
Entity Type:Organization
Organization Name:EILEEN GERALYN CEJKA
Other - Org Name:ASSABET VALLEY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:GERALYN
Authorized Official - Last Name:CEJKA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:978-897-8276
Mailing Address - Street 1:1 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:MAYNARD
Mailing Address - State:MA
Mailing Address - Zip Code:01754-1360
Mailing Address - Country:US
Mailing Address - Phone:978-897-8276
Mailing Address - Fax:978-897-8825
Practice Address - Street 1:1 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:MAYNARD
Practice Address - State:MA
Practice Address - Zip Code:01754-1360
Practice Address - Country:US
Practice Address - Phone:978-897-8276
Practice Address - Fax:978-897-8825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA442000OtherUHC