1295860021 NPI number — DR. SHAYLA S CARON D.C.

Table of content: DR. SHAYLA S CARON D.C. (NPI 1295860021)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295860021 NPI number — DR. SHAYLA S CARON D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARON
Provider First Name:
SHAYLA
Provider Middle Name:
S
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295860021
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/30/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1005 OSGOOD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH ANDOVER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01845-1501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-476-6301
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1005 OSGOOD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH ANDOVER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01845-1501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-965-4925
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2935 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1304216 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 672509 . This is a "UNITED" identifier . This identifiers is of the category "OTHER".
  • Identifier: Y39863 . This is a "BCBSMA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 5619486 . This is a "COVENTRY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9755161 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: AA39431 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 05Y008175MA01 . This is a "ANTHEM" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".




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