Provider Demographics
NPI:1376682617
Name:ARCHAMBAULT, N. RICHARD (DC)
Entity Type:Individual
Prefix:DR
First Name:N.
Middle Name:RICHARD
Last Name:ARCHAMBAULT
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 1:9 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-1225
Mailing Address - Country:US
Mailing Address - Phone:781-646-8400
Mailing Address - Fax:781-648-9325
Practice Address - Street 1:9 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-1225
Practice Address - Country:US
Practice Address - Phone:781-646-8400
Practice Address - Fax:781-648-9325
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA525111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA350003OtherFIRST SENORITY
MA049-46-13OtherAETNA
MAP00202666OtherRAILROAD MEDICARE
MA350003OtherHARVARD PILGRIM
MAY35349OtherBLUE CROSS BLUE SHIELD
MA712996OtherTUFTS HEALTHCARE
MAY35349Medicare ID - Type Unspecified