Provider Demographics
NPI:1376864223
Name:ROBERT E. LAKATOS
Entity Type:Organization
Organization Name:ROBERT E. LAKATOS
Other - Org Name:MASHPEE CHIROPRACTIC AND FALMOUTH CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:LAKATOS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-477-8242
Mailing Address - Street 1:759 FALMOUTH RD UNIT 3
Mailing Address - Street 2:
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-3371
Mailing Address - Country:US
Mailing Address - Phone:508-477-8242
Mailing Address - Fax:508-477-8243
Practice Address - Street 1:759 FALMOUTH RD UNIT 3
Practice Address - Street 2:
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-3371
Practice Address - Country:US
Practice Address - Phone:508-477-8242
Practice Address - Fax:508-477-8243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-15
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2586111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA606800OtherCIGNA
MA351352OtherHARVARD PILGRIM
MA6688624OtherTUFTS
MAY36799OtherBLUE CROSS/BLUE SHIELD
MAY36799OtherBLUE CROSS/BLUE SHIELD
MA6688624OtherTUFTS