Provider Demographics
NPI:1487771044
Name:NEW ENGLAND CHIROPRACTIC HEALTH CLINIC, INC.
Entity type:Organization
Organization Name:NEW ENGLAND CHIROPRACTIC HEALTH CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDRICK
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHASSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-795-1555
Mailing Address - Street 1:192 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2501
Mailing Address - Country:US
Mailing Address - Phone:508-795-1555
Mailing Address - Fax:508-755-4464
Practice Address - Street 1:192 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2501
Practice Address - Country:US
Practice Address - Phone:508-795-1555
Practice Address - Fax:508-755-4464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1492111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY39546OtherBLUE CROSS MA
Y49061OtherMEDICARE PART B