MEDICARE: DR. ALLISON MENDELSON D.C.

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	1898	MA
2	111N00000X	Chiropractor	1740	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	351175	OTHER	MA	HARVARD PILGRIM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	771717	OTHER	MA	GIC INDEMNITY
4	771717	OTHER	MA	TUFTS HEALTH
5	263444980	OTHER		1447387162
6	5283290	OTHER	MA	AETNA INDEMNITY
7	Y36408	OTHER	MA	BCBS

General Provider Information

NPI Number	:	1447387162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLISON MENDELSON D.C.

Provider Business Mailing Address
First Line	:	74 PARK RD
Second Line	:
City	:	WEST HARTFORD
State	:	CT
Zip	:	06119-1853
Country	:	US
Telephone Number	:	860-269-3228
Fax Number	:	860-269-3229

Provider Business Practice Location Address
First Line	:	74 PARK RD
Second Line	:
City	:	WEST HARTFORD
State	:	CT
Zip	:	06119-1853
Country	:	US
Telephone Number	:	860-269-3228
Fax Number	:	860-269-3229

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

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	12/08/2022

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