MEDICARE: DR. BRIAN V AVITABILE DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2237	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00462880	OTHER	MA	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AA118684	OTHER	MA	HARVARD PILGRIM HEALTHCARE
2	6342264	OTHER	MA	CIGNA
3	Y36619	OTHER	MA	BCBS MA
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730161183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN V AVITABILE DC

Provider Business Mailing Address
First Line	:	1665 FALMOUTH RD
Second Line	:
City	:	CENTERVILLE
State	:	MA
Zip	:	02632-2944
Country	:	US
Telephone Number	:	508-778-5005
Fax Number	:	508-778-5006

Provider Business Practice Location Address
First Line	:	1665 FALMOUTH RD
Second Line	:
City	:	CENTERVILLE
State	:	MA
Zip	:	02632-2944
Country	:	US
Telephone Number	:	508-778-5005
Fax Number	:	508-778-5006

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	07/21/2022

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Directions to “ DR. BRIAN V AVITABILE DC” Practice Location

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