Provider Demographics
NPI:1942391453
Name:MORAMARCO CHIROPRACTIC OFFICE, P.C.
Entity Type:Organization
Organization Name:MORAMARCO CHIROPRACTIC OFFICE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MORAMARCO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:781-938-8558
Mailing Address - Street 1:3 BALDWIN GREEN CMN
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-1865
Mailing Address - Country:US
Mailing Address - Phone:781-938-8558
Mailing Address - Fax:781-933-9934
Practice Address - Street 1:3 BALDWIN GREEN CMN
Practice Address - Street 2:SUITE 204
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-1865
Practice Address - Country:US
Practice Address - Phone:781-938-8558
Practice Address - Fax:781-933-9934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1139111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY39197OtherGROUP NUMBER
MAY49131Medicare ID - Type UnspecifiedGROUP NUMBER