Healthcare Provider Details

I. General information

NPI: 1962407262
Provider Name (Legal Business Name): MICHAEL CAREY SANTIPADRI D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

667 BOYLSTON ST 4TH FLOOR
BOSTON MA
02116-4809
US

IV. Provider business mailing address

667 BOYLSTON ST 4TH FLOOR
BOSTON MA
02116-4809
US

V. Phone/Fax

Practice location:
  • Phone: 617-421-1881
  • Fax: 617-236-0359
Mailing address:
  • Phone: 617-421-1881
  • Fax: 617-236-0359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH 2861
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: