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NPI Code Detail

MEDICARE: DR. KEITH M PURI D.C.

MEDICARE: DR. KEITH M PURI 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
1111N00000XChiropractor2830MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Y36964OTHERMABLUECROSS/BLUESHIELD
2AA47417OTHERMAHARVARD PILGRIM

General Provider Information

NPI Number : 1962468439
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEITH M PURI D.C.
Provider Business Mailing Address
First Line : 406 MASSACHUSETTS AVE
Second Line :
City : ARLINGTON
State : MA
Zip : 02474-6700
Country : US
Telephone Number : 781-488-3388
Fax Number : 781-488-3363
Provider Business Practice Location Address
First Line : 403 BELMONT ST
Second Line :
City : WORCESTER
State : MA
Zip : 01604-1019
Country : US
Telephone Number : 508-425-2600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2006
Last Update Date : 10/05/2023

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