Provider Demographics
NPI:1912014226
Name:ERMILIO, FRANCIS P (DC)
Entity Type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:P
Last Name:ERMILIO
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 1:3 RUTHVEN AVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2827
Mailing Address - Country:US
Mailing Address - Phone:508-854-4868
Mailing Address - Fax:508-853-9271
Practice Address - Street 1:3 RUTHVEN AVE
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01606-2827
Practice Address - Country:US
Practice Address - Phone:508-854-4868
Practice Address - Fax:508-853-9271
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1133111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1610007Medicaid
MAT97036Medicare UPIN
MAY36085Medicare ID - Type Unspecified