Provider Demographics
NPI:1982773628
Name:LANCELLOTTI, JOSEPH L (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:L
Last Name:LANCELLOTTI
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 1:1524 ATWOOD AVE
Mailing Address - Street 2:SUITE 210A
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-3228
Mailing Address - Country:US
Mailing Address - Phone:401-274-9355
Mailing Address - Fax:401-455-0290
Practice Address - Street 1:1524 ATWOOD AVE
Practice Address - Street 2:SUITE 210A
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3228
Practice Address - Country:US
Practice Address - Phone:401-274-9355
Practice Address - Fax:401-455-0290
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00199111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
646694OtherOPTUM
RI77842OtherBLUE CROSS BLUE SHIELD
RI401256OtherBLUE CHIP
1123660OtherAMERICAN SPECIALTY HEALTH
RI4400193OtherUNITED HEALTHCARE
RI77842OtherBLUE CROSS BLUE SHIELD
1123660OtherAMERICAN SPECIALTY HEALTH