Provider Demographics
NPI:1649489063
Name:NAIR, ANIL R (DC)
Entity type:Individual
Prefix:DR
First Name:ANIL
Middle Name:R
Last Name:NAIR
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 1:1912 DORCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124-3765
Mailing Address - Country:US
Mailing Address - Phone:617-506-8834
Mailing Address - Fax:617-506-8934
Practice Address - Street 1:1912 DORCHESTER AVE
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02124-3765
Practice Address - Country:US
Practice Address - Phone:617-506-8834
Practice Address - Fax:617-506-8934
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACH2560111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor