Provider Demographics
NPI:1902952484
Name:NEIL P OBRIEN
Entity Type:Organization
Organization Name:NEIL P OBRIEN
Other - Org Name:COTUIT CHIROPRACTIC AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-428-9441
Mailing Address - Street 1:4650 ROUTE 28
Mailing Address - Street 2:
Mailing Address - City:COTUIT
Mailing Address - State:MA
Mailing Address - Zip Code:02635-2534
Mailing Address - Country:US
Mailing Address - Phone:508-428-9441
Mailing Address - Fax:508-428-9750
Practice Address - Street 1:4650 ROUTE 28
Practice Address - Street 2:
Practice Address - City:COTUIT
Practice Address - State:MA
Practice Address - Zip Code:02635-2534
Practice Address - Country:US
Practice Address - Phone:508-428-9441
Practice Address - Fax:508-428-9750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2357111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY39837OtherBCBS
MA642685OtherTUFTS HEALTH PLAN
MAY49196Medicare PIN
MAY49196Medicare PIN
=========OtherGIC
MA352512OtherHARVARD PILGRIM
MA3685851OtherAETNA
MA7639614OtherCIGNA
MAY39836OtherBLUE CROSS GROUP #
MA642685OtherGROUP TUFTS #
MAU90189Medicare UPIN