Provider Demographics
NPI:1518962844
Name:KANTOROSINSKI CHIROPRACTIC INC
Entity Type:Organization
Organization Name:KANTOROSINSKI CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MIROSLAW
Authorized Official - Middle Name:
Authorized Official - Last Name:KANTOROSINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:978-741-3477
Mailing Address - Street 1:407 ESSEX ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-3155
Mailing Address - Country:US
Mailing Address - Phone:978-741-3477
Mailing Address - Fax:978-744-7757
Practice Address - Street 1:407 ESSEX ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-3155
Practice Address - Country:US
Practice Address - Phone:978-741-3477
Practice Address - Fax:978-744-7757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA859111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
694 485OtherTUFTS
354-33OtherHARVARD PILGRIM HEALTH CA
Y39632OtherBLUE CROSS & BLUE SHIELD
694 485OtherTUFTS