Provider Demographics
NPI:1740288182
Name:PACI, ATTILIO A (DC)
Entity type:Individual
Prefix:DR
First Name:ATTILIO
Middle Name:A
Last Name:PACI
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 1:200 NORTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-2920
Mailing Address - Country:US
Mailing Address - Phone:717-263-6498
Mailing Address - Fax:
Practice Address - Street 1:200 NORTHERN AVE
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-2920
Practice Address - Country:US
Practice Address - Phone:301-733-4445
Practice Address - Fax:301-733-3383
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03436111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD352258194OtherEMPLOYEE ID
MDPA1739401OtherHIGHMARK BLUE CROSS BLUE
MDPA1739401OtherHIGHMARK BLUE CROSS BLUE
MD227N245GMedicare UPIN