Provider Demographics
NPI:1275725350
Name:CARNABUCI, DAVID LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LEE
Last Name:CARNABUCI
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 1:30 MAN MAR DR
Mailing Address - Street 2:SUITE 10
Mailing Address - City:PLAINVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02762-2271
Mailing Address - Country:US
Mailing Address - Phone:508-643-0042
Mailing Address - Fax:508-643-0225
Practice Address - Street 1:30 MAN MAR DR
Practice Address - Street 2:SUITE 10
Practice Address - City:PLAINVILLE
Practice Address - State:MA
Practice Address - Zip Code:02762-2271
Practice Address - Country:US
Practice Address - Phone:508-643-0042
Practice Address - Fax:508-643-0225
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1416111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY36002OtherBCBS
MA9550667OtherCIGNA
MAAA100189OtherHARVARD PILGRIM
MA1613693Medicaid
MA5426420OtherAETNA
MA1613693Medicaid