Provider Demographics
NPI:1801917901
Name:BAY CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:BAY CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:ROSA
Authorized Official - Last Name:IVALDI
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CCSP
Authorized Official - Phone:508-880-1556
Mailing Address - Street 1:20 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-2733
Mailing Address - Country:US
Mailing Address - Phone:508-880-1556
Mailing Address - Fax:508-880-0491
Practice Address - Street 1:20 MAIN ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2733
Practice Address - Country:US
Practice Address - Phone:508-880-1556
Practice Address - Fax:508-880-0491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1204111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0736083OtherAETNA
MAY39332OtherBLUE CROSS & BLUE SHIELD
MA715095OtherTUFTS
MA210894OtherANC GROUP
RI233602OtherBLUE CROSS & BLUE SHIELD
MA4400119OtherUNITED HEALTHCARE
MA351132OtherHARVARD PILGRIM
MA=========OtherGIC UNICARE
MA0736083OtherAETNA
MAT58426Medicare UPIN
MA210894OtherANC GROUP