1497719280 NPI number — DR. IAN CHARLES PASKOWSKI D.C.

Table of content: DR. IAN CHARLES PASKOWSKI D.C. (NPI 1497719280)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497719280 NPI number — DR. IAN CHARLES PASKOWSKI D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PASKOWSKI
Provider First Name:
IAN
Provider Middle Name:
CHARLES
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

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:
1497719280
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 CORDAGE PARK CIR STE 225
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLYMOUTH
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02360-7318
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-830-6991
Provider Business Mailing Address Fax Number:
508-830-6993

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 CORDAGE PARK CIR STE 225
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLYMOUTH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02360-7318
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-830-6991
Provider Business Practice Location Address Fax Number:
508-830-6993
Provider Enumeration Date:
04/17/2006

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:  2706 , 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: 2662539 . This is a "CIGNA PIN #" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 3147416 . This is a "AETNA PIN #" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: Y36876 . This is a "BCBS OF MASS INDIVIDUAL #" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 352348 . This is a "HARVARD PILGRIM PIN #" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 7932344 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: AA115064 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: Y39897 . This is a "BCBS OF MASS GROUP#" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1611020 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 648876 . This is a "UNITED HEALTHCARE PIN #" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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