Provider Demographics
NPI:1437197969
Name:ASSOCIATED SPINE AND REHAB
Entity Type:Organization
Organization Name:ASSOCIATED SPINE AND REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:T
Authorized Official - Last Name:GIAMPA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:978-250-0230
Mailing Address - Street 1:73 PRINCETON ST
Mailing Address - Street 2:SUITE 214
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-1558
Mailing Address - Country:US
Mailing Address - Phone:978-250-0230
Mailing Address - Fax:978-250-8424
Practice Address - Street 1:938 STATE ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-3928
Practice Address - Country:US
Practice Address - Phone:203-562-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC03065Medicare ID - Type Unspecified