Provider Demographics
NPI:1457469173
Name:DUBIN, JOSHUA (DC, CCSP, CSCS)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
Last Name:DUBIN
Suffix:
Gender:M
Credentials:DC, CCSP, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 HANCOCK ST
Mailing Address - Street 2:SUITE 106N
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4339
Mailing Address - Country:US
Mailing Address - Phone:617-471-2444
Mailing Address - Fax:617-471-3357
Practice Address - Street 1:1250 HANCOCK ST
Practice Address - Street 2:SUITE 106N
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4339
Practice Address - Country:US
Practice Address - Phone:617-471-2444
Practice Address - Fax:617-471-3357
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1914111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY45085Medicare ID - Type Unspecified