Healthcare Provider Details

I. General information

NPI: 1437109261
Provider Name (Legal Business Name): VLADIMIR BARIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 10/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

556 CAMBRIDGE ST
ALLSTON MA
02134-2496
US

IV. Provider business mailing address

510 BAKER ST
WEST ROXBURY MA
02132-4238
US

V. Phone/Fax

Practice location:
  • Phone: 617-782-5100
  • Fax: 617-782-5122
Mailing address:
  • Phone: 617-782-5100
  • Fax: 617-782-5122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2641
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: