Provider Demographics
NPI:1477699841
Name:DR. ANGELO GIOLEKAS
Entity Type:Organization
Organization Name:DR. ANGELO GIOLEKAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELO
Authorized Official - Middle Name:
Authorized Official - Last Name:GIOLEKAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-752-7334
Mailing Address - Street 1:617 CHANDLER ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602-1753
Mailing Address - Country:US
Mailing Address - Phone:508-752-7334
Mailing Address - Fax:
Practice Address - Street 1:617 CHANDLER ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602-1753
Practice Address - Country:US
Practice Address - Phone:508-752-7334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACH2228111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA11456131Medicare UPIN
MAGIY39517Medicare UPIN
MA798099Medicare UPIN
MAGIY36558Medicare UPIN
MAGIY45174Medicare ID - Type Unspecified