Provider Demographics
NPI:1245418516
Name:CARNABUCI CHIROPRACTIC PC
Entity type:Organization
Organization Name:CARNABUCI CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CARNABUCI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-643-0042
Mailing Address - Street 1:30 MAN MAR DR
Mailing Address - Street 2:SUITE 10
Mailing Address - City:PLAINVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02762-2271
Mailing Address - Country:US
Mailing Address - Phone:508-643-0042
Mailing Address - Fax:508-643-0225
Practice Address - Street 1:30 MAN MAR DR
Practice Address - Street 2:SUITE 10
Practice Address - City:PLAINVILLE
Practice Address - State:MA
Practice Address - Zip Code:02762-2271
Practice Address - Country:US
Practice Address - Phone:508-643-0042
Practice Address - Fax:508-643-0225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1416111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5426420OtherAETNA
MA1613693Medicaid
MA648412OtherUNITED HEALTHCARE
MA9550667OtherCIGNA
MAAA100189OtherHARVARD PILGRIM
MAY36002OtherBCBS
MA1613693Medicaid