Provider Demographics
NPI:1891828802
Name:CHIROPRACTIC HEALTH PARTNERS OF AMERICA LTD.
Entity Type:Organization
Organization Name:CHIROPRACTIC HEALTH PARTNERS OF AMERICA LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SEQUINO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:401-247-7442
Mailing Address - Street 1:446 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:RI
Mailing Address - Zip Code:02885-4370
Mailing Address - Country:US
Mailing Address - Phone:401-247-7442
Mailing Address - Fax:401-247-7443
Practice Address - Street 1:446 MAIN ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:RI
Practice Address - Zip Code:02885-4370
Practice Address - Country:US
Practice Address - Phone:401-247-7442
Practice Address - Fax:401-247-7443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00507111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI29020-3OtherBLUE CROSS BLUE SHIELD
V04132Medicare UPIN
709004036Medicare ID - Type Unspecified