Provider Demographics
NPI:1083705370
Name:CHICOPEE CENTER CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:CHICOPEE CENTER CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PRZEZDZIECKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:413-598-8550
Mailing Address - Street 1:333 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01013-3194
Mailing Address - Country:US
Mailing Address - Phone:413-598-8550
Mailing Address - Fax:413-598-8556
Practice Address - Street 1:333 FRONT ST
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01013-3194
Practice Address - Country:US
Practice Address - Phone:413-598-8550
Practice Address - Fax:413-598-8556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1925111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2552470OtherAETNA
MA000000034224OtherBMC HEALTH NET
MA1612042OtherMASSHEALTH
MA8461730OtherCIGNA
MAY36393OtherBLUE CROSS BLUE SHIELD
MAY36393OtherBLUE CROSS BLUE SHIELD