Provider Demographics
NPI:1497719280
Name:PASKOWSKI, IAN CHARLES (DC)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:CHARLES
Last Name:PASKOWSKI
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 1:10 CORDAGE PARK CIR STE 225
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-7318
Mailing Address - Country:US
Mailing Address - Phone:508-830-6991
Mailing Address - Fax:508-830-6993
Practice Address - Street 1:10 CORDAGE PARK CIR STE 225
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-7318
Practice Address - Country:US
Practice Address - Phone:508-830-6991
Practice Address - Fax:508-830-6993
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2706111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2662539OtherCIGNA PIN #
MA3147416OtherAETNA PIN #
MAY36876OtherBCBS OF MASS INDIVIDUAL #
MA352348OtherHARVARD PILGRIM PIN #
MA7932344OtherAETNA
MAAA115064OtherHARVARD PILGRIM
MAY39897OtherBCBS OF MASS GROUP#
MA1611020Medicaid
MA648876OtherUNITED HEALTHCARE PIN #
MA7932344OtherAETNA
MA2662539OtherCIGNA PIN #
U91847Medicare UPIN
MA352348OtherHARVARD PILGRIM PIN #