Provider Demographics
NPI:1497870414
Name:DUPILKA, SEAN S (DC)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:S
Last Name:DUPILKA
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 1:48 CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-5137
Mailing Address - Country:US
Mailing Address - Phone:978-745-6224
Mailing Address - Fax:978-745-8112
Practice Address - Street 1:48 CONGRESS ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-5137
Practice Address - Country:US
Practice Address - Phone:978-745-6224
Practice Address - Fax:978-745-8112
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2287111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY45707Medicare ID - Type UnspecifiedPERSONAL NUMBER
MAY49143Medicare ID - Type UnspecifiedOFFICE GROUP NUMBER