1386744837 NPI number — ANTONIO DACUNHA DC

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386744837 NPI number — ANTONIO DACUNHA DC

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

DACUNHA

Provider First Name:

ANTONIO

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

DC

Provider Gender Code:

M

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:

1386744837

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

06/09/2010

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

161 WILLIAM ST

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

NEW BEDFORD

Provider Business Mailing Address State Name:

MA

Provider Business Mailing Address Postal Code:

02740-6021

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

508-984-8000

Provider Business Mailing Address Fax Number:

508-984-8102

Provider First Line Business Practice Location Address:

161 WILLIAM ST

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

NEW BEDFORD

Provider Business Practice Location Address State Name:

MA

Provider Business Practice Location Address Postal Code:

02740-6021

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

508-984-8000

Provider Business Practice Location Address Fax Number:

508-984-8102

Provider Enumeration Date:

09/25/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 111N00000X , with the licence number:  1840 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
• Taxonomy code: 111N00000X , with the licence number: DCP00491 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

• Identifier: 263092 . This is a "BCBS OF RI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
• Identifier: 263092 . This is a "BC RI" identifier . This identifiers is of the category "OTHER".
• Identifier: Y36317DA . This is a "BC MA" identifier . This identifiers is of the category "OTHER".
• Identifier: 0023606 . This is a "NEIGHBORHOOD HEALTH" identifier . This identifiers is of the category "OTHER".
• Identifier: 1610619 . This is a "MEDICAIDE" identifier . This identifiers is of the category "OTHER".
• Identifier: 391886617 . This is a "HCVM" identifier . This identifiers is of the category "OTHER".
• Identifier: 401358 . This is a "BCHIP" identifier . This identifiers is of the category "OTHER".
• Identifier: 1000080 . This is a "AMERICAN SPECIALTY" identifier . This identifiers is of the category "OTHER".
• Identifier: 4400419 . This is a "UHEALTH" identifier . This identifiers is of the category "OTHER".
• Identifier: 1610619 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
• Identifier: B20922001 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
• Identifier: Y36317 . This is a "BLUE CROSS BLUE SHIELD MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".