Provider Demographics
NPI:1578666236
Name:GIRARDI, N ROBERT (DC)
Entity Type:Individual
Prefix:
First Name:N
Middle Name:ROBERT
Last Name:GIRARDI
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 1:1 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-4792
Mailing Address - Country:US
Mailing Address - Phone:781-229-6333
Mailing Address - Fax:781-229-6335
Practice Address - Street 1:1 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-4792
Practice Address - Country:US
Practice Address - Phone:781-229-6333
Practice Address - Fax:781-229-6335
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1585111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY36114Medicare ID - Type Unspecified
Y36114Medicare UPIN