Provider Demographics
NPI:1710102504
Name:ASDOURIAN, ESTHER K (DC)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:K
Last Name:ASDOURIAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 TERRACE HALL AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-3512
Mailing Address - Country:US
Mailing Address - Phone:781-750-8206
Mailing Address - Fax:781-750-8206
Practice Address - Street 1:45 TERRACE HALL AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-3512
Practice Address - Country:US
Practice Address - Phone:781-750-8206
Practice Address - Fax:781-750-8206
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2110111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1613464Medicaid
MA2595429OtherAETNA
MAY36513OtherBCBS
MAY36513OtherBCBS
MA2595429OtherAETNA