Provider Demographics
NPI:1720261571
Name:ANASTASIO FAMILY CHIROPRACTIC,P.C.
Entity type:Organization
Organization Name:ANASTASIO FAMILY CHIROPRACTIC,P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:ANASTASIO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-432-7855
Mailing Address - Street 1:11 PLEASANT LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02645-2661
Mailing Address - Country:US
Mailing Address - Phone:508-432-7855
Mailing Address - Fax:508-432-5088
Practice Address - Street 1:11 PLEASANT LAKE AVE
Practice Address - Street 2:
Practice Address - City:HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02645-2661
Practice Address - Country:US
Practice Address - Phone:508-432-7855
Practice Address - Fax:508-432-5088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-14
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1836111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA35149OtherHARVARD PILGRIM
MA9727329Medicaid
MAY39560OtherBLUE CROSS/BLUE SHIELD
MA001836OtherTUFTS
MA9727329Medicaid