1710006804 NPI number — SWIESZ FAMILY CHIROPRACTIC LLC

Table of content: (NPI 1710006804)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710006804 NPI number — SWIESZ FAMILY CHIROPRACTIC LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SWIESZ FAMILY CHIROPRACTIC LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1710006804
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
320 SANDOWN RD UNIT 1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAST HAMPSTEAD
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03826-5411
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-329-5491
Provider Business Mailing Address Fax Number:
603-329-5907

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
320 SANDOWN RD UNIT 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST HAMPSTEAD
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03826-5411
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-329-5491
Provider Business Practice Location Address Fax Number:
603-329-5907
Provider Enumeration Date:
03/28/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SWIESZ
Authorized Official First Name:
MATTHEW
Authorized Official Middle Name:
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
603-329-5491

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  589-0200 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 111N00000X , with the licence number: 590-0200 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 05OO3957 NH . This is a "MATT BCBS" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: P00176465 . This is a "MATT RR MEDICARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: AA60774 . This is a "MATT HARVARD" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 05YOO3966 NH . This is a "WHITNEY BCBS" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: AA60793 . This is a "WHITNEY HP" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 3502354 . This is a "CIGNA MATT" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 6765688 . This is a "WHITNEY CIGNA" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".




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