MEDICARE: JUSTINE FAZIO PAULA DC

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	3433	MA

General Provider Information

NPI Number	:	1700210812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTINE FAZIO PAULA DC

Provider Business Mailing Address
First Line	:	1620 BEACON ST
Second Line	:
City	:	BROOKLINE
State	:	MA
Zip	:	02446-2270
Country	:	US
Telephone Number	:	617-505-6742
Fax Number	:	617-505-6769

Provider Business Practice Location Address
First Line	:	1620 BEACON ST
Second Line	:
City	:	BROOKLINE
State	:	MA
Zip	:	02446-2270
Country	:	US
Telephone Number	:	617-505-6742
Fax Number	:	617-505-6769

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

Provider Enumeration Date	:	08/26/2013
Last Update Date	:	07/30/2018

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Directions to “ JUSTINE FAZIO PAULA DC” Practice Location

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