Healthcare Provider Details

I. General information

NPI: 1568467181
Provider Name (Legal Business Name): AVA L. HENDERSON-RONCHETTI DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AVA L RONCHETTI DC

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 EASTERN AVE STE 3
MALDEN MA
02148-5910
US

IV. Provider business mailing address

24 PIERCE AVE
DERRY NH
03038-2116
US

V. Phone/Fax

Practice location:
  • Phone: 781-605-0126
  • Fax:
Mailing address:
  • Phone: 617-642-9456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2219
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: