Provider Demographics
NPI:1497977656
Name:CARLO L ZELANO DC PC
Entity Type:Organization
Organization Name:CARLO L ZELANO DC PC
Other - Org Name:COURT SQUARE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLO
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZELANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:617-742-5555
Mailing Address - Street 1:15 COURT SQ
Mailing Address - Street 2:SUITE 150
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02108-2503
Mailing Address - Country:US
Mailing Address - Phone:617-742-5555
Mailing Address - Fax:617-742-6886
Practice Address - Street 1:15 COURT SQ
Practice Address - Street 2:SUITE 150
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02108-2503
Practice Address - Country:US
Practice Address - Phone:617-742-5555
Practice Address - Fax:617-742-6886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1570111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA729536OtherTUFTS
MAY39092OtherBLUE CROSS BLUE SHIELD
MAU13606Medicare UPIN