Provider Demographics
NPI:1932360872
Name:GERALD NADEAU DC PA
Entity Type:Organization
Organization Name:GERALD NADEAU DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:NADEAU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:207-777-1104
Mailing Address - Street 1:336 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-6300
Mailing Address - Country:US
Mailing Address - Phone:207-777-1104
Mailing Address - Fax:207-777-7354
Practice Address - Street 1:336 CENTER ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-6300
Practice Address - Country:US
Practice Address - Phone:207-777-1104
Practice Address - Fax:207-777-7354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-23
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR653111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty