Healthcare Provider Details

I. General information

NPI: 1275591810
Provider Name (Legal Business Name): PIERRE DANIEL ABDILMASIH D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 BLUE HILL AVE
ROXBURY MA
02119-2152
US

IV. Provider business mailing address

1 MARGARETS CV
FRANKLIN MA
02038-2792
US

V. Phone/Fax

Practice location:
  • Phone: 617-989-8881
  • Fax:
Mailing address:
  • Phone: 508-446-5955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number2880
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: