Provider Demographics
NPI:1346386141
Name:PINTO, LORI
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:PINTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:STIEFVATER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:632 ROUTE 6A
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH PORT
Mailing Address - State:MA
Mailing Address - Zip Code:02675-2039
Mailing Address - Country:US
Mailing Address - Phone:508-362-9023
Mailing Address - Fax:
Practice Address - Street 1:632 ROUTE 6A
Practice Address - Street 2:
Practice Address - City:YARMOUTH PORT
Practice Address - State:MA
Practice Address - Zip Code:02675-2039
Practice Address - Country:US
Practice Address - Phone:508-362-9023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2064111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAU64135Medicare UPIN
MAY45419Medicare ID - Type Unspecified