Provider Demographics
NPI:1265543243
Name:PRZEZDZIECKI, STEVEN (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:PRZEZDZIECKI
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 1:333 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01013-3194
Mailing Address - Country:US
Mailing Address - Phone:413-598-8550
Mailing Address - Fax:413-598-8556
Practice Address - Street 1:333 FRONT ST
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01013-3194
Practice Address - Country:US
Practice Address - Phone:413-598-8550
Practice Address - Fax:413-598-8556
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1925111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2552470OtherAETNA
MA000000034224OtherBMC HEALTH NET
MA8461730OtherCIGNA
MA1612042OtherMASSHEALTH
MAY36393OtherBLUE CROSS BLUE SHIELD
MAY36393OtherBLUE CROSS BLUE SHIELD