Provider Demographics
NPI:1154344885
Name:FURTADO, ALFRED BORGES (DC)
Entity type:Individual
Prefix:
First Name:ALFRED
Middle Name:BORGES
Last Name:FURTADO
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 1:2415 BOSTON POST RD
Mailing Address - Street 2:UNIT 11
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-4348
Mailing Address - Country:US
Mailing Address - Phone:203-453-2001
Mailing Address - Fax:203-453-2010
Practice Address - Street 1:2415 BOSTON POST RD
Practice Address - Street 2:UNIT 11
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-4348
Practice Address - Country:US
Practice Address - Phone:203-453-2001
Practice Address - Fax:203-453-2010
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001647111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT11513740OtherCAQH
CT691498OtherACN
CT7165761OtherAETNA
CTCT001647OtherLANDMARK/HEALTHNET
CT05-0001647CT01OtherANTHEM BLUE CROSS
CTCT001647OtherLANDMARK/HEALTHNET