MEDICARE: BROOKLINE NEWTON WHOLE HEALTH CENTER

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	2710	MA
2	111N00000X	Chiropractor	3064	MA
3	111N00000X	Chiropractor	1405	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	35472	OTHER	MA	DEBORAH WU HPHC
2	Y39428	OTHER	MA	BCBS GROUP
3	3830317	OTHER	MA	LYDIE COLEMAN AETNA
4	2490916	OTHER	MA	DEBORAH WU AETNA
5	31221	OTHER	MA	LYDIE COLEMAN HPHC
6	44-00391	OTHER	MA	DEBORAH WU UNITED HC/ACN
7	668803	OTHER	MA	LYDIE COLEMAN UNITED HC

General Provider Information

NPI Number	:	1720024268
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROOKLINE NEWTON WHOLE HEALTH CENTER

Provider Business Mailing Address
First Line	:	PO BOX 320258
Second Line	:
City	:	WEST ROXBURY
State	:	MA
Zip	:	02132-0003
Country	:	US
Telephone Number	:	617-413-8362
Fax Number	:

Provider Business Practice Location Address
First Line	:	960 CENTRE ST
Second Line	:
City	:	JAMAICA PLAIN
State	:	MA
Zip	:	02130-3045
Country	:	US
Telephone Number	:	617-413-8362
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DEBORAH WU
Credential	:	D.C.
Telephone Number	:	617-413-8362

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	10/25/2010

Similar Medicare Providers

1891788469 — DEBORAH WU D.C.
Practice Location Address:

960 CENTRE ST
JAMAICA PLAIN, MA
02130-3045

Practice Phone: 617-413-8362
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1013890433 — HEENA NISSARALY DNP, RN, AGNP-C
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1700737541 — HAOLAT D. SADIKU
Practice Location Address:

103 DAY ST APT 1
JAMAICA PLAIN, MA
02130-1482

Practice Phone: 404-543-9099
Practice Fax:

1225037070 — MS. ANDREA C SOLER LICSW
Practice Location Address:

640 CENTRE ST
JAMAICA PLAIN, MA
02130-2555

Practice Phone: 617-264-9977
Practice Fax:

1346241569 — DR. DANIEL F MELVILLE MD
Practice Location Address:

545 A CENTRE ST , BETH ISRAEL DEACONESS HEALTH CARE - JAMAICA PLAIN
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02130-2071

Practice Phone: 617-522-5464
Practice Fax: 617-524-2966

Directions to “BROOKLINE NEWTON WHOLE HEALTH CENTER ” Practice Location

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