Provider Demographics
NPI:1952403032
Name:MCCAULEY, SEAN E (DC)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:E
Last Name:MCCAULEY
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 1:31 LAKE ST
Mailing Address - Street 2:SUITE 151
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-3879
Mailing Address - Country:US
Mailing Address - Phone:978-632-9500
Mailing Address - Fax:978-632-9579
Practice Address - Street 1:31 LAKE ST
Practice Address - Street 2:SUITE 151
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440
Practice Address - Country:US
Practice Address - Phone:978-632-9500
Practice Address - Fax:978-632-9579
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2562111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY45422Medicare ID - Type Unspecified
MAU84954Medicare UPIN