Provider Demographics
NPI:1285683458
Name:HANLON-CAVICCHI, GINA (DC)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:
Last Name:HANLON-CAVICCHI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:HANLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
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
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2009-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1922111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA461123OtherTUFTS
MA1873815OtherCIGNA
MA351403OtherHARVARD PILGRIM
MAY36854OtherBLUE CROSS BLUE SHEILD
MA786919OtherMVP
MA3207736OtherAETNA
MAY45526Medicare ID - Type Unspecified