Provider Demographics
NPI:1407962525
Name:TODOROV, OTTO (DC)
Entity Type:Individual
Prefix:DR
First Name:OTTO
Middle Name:
Last Name:TODOROV
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 1:105 CHESTNUT ST
Mailing Address - Street 2:SUITE 35
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-2599
Mailing Address - Country:US
Mailing Address - Phone:781-444-3772
Mailing Address - Fax:781-444-7427
Practice Address - Street 1:105 CHESTNUT ST
Practice Address - Street 2:SUITE 35
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2599
Practice Address - Country:US
Practice Address - Phone:781-444-3772
Practice Address - Fax:781-444-7427
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA1076111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY35756OtherBCBSMA
MA288140OtherCIGNA
MA35450OtherHARVARDPILGRIM HC
MA481021OtherAETNA
MA761746OtherTUFTS HEALTH PLANS
MA1607847OtherMASSHEALTH
MA4400166OtherUNITEDHEALTHCARE
MA1607847OtherMASSHEALTH
MA761746OtherTUFTS HEALTH PLANS