Provider Demographics
NPI:1427023050
Name:DEFINO, CLAUDIA (DC)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:DEFINO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 CHANDLER ST
Mailing Address - Street 2:#2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-6063
Mailing Address - Country:US
Mailing Address - Phone:617-859-8999
Mailing Address - Fax:
Practice Address - Street 1:450 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-2536
Practice Address - Country:US
Practice Address - Phone:508-583-2565
Practice Address - Fax:508-580-2477
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1913111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1609874Medicaid
U65724Medicare UPIN
MADEY45109Medicare ID - Type Unspecified