Provider Demographics
NPI:1144339227
Name:GOYETTE, DOLORES M (DC)
Entity type:Individual
Prefix:DR
First Name:DOLORES
Middle Name:M
Last Name:GOYETTE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 HAVERHILL ST
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-3002
Mailing Address - Country:US
Mailing Address - Phone:978-475-2785
Mailing Address - Fax:801-346-6944
Practice Address - Street 1:16 HAVERHILL ST
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-3002
Practice Address - Country:US
Practice Address - Phone:978-475-2785
Practice Address - Fax:801-346-6944
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1872111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY35345OtherBCBS INDIVIDUAL
MAY39888OtherMEDEX
MA001-872OtherTUFTS HEALTH PLAN
MA44-00556OtherUNITED HEALTH CARE
MAY39285OtherBCBS GROUP
MA2243351OtherAETNA US HEALTHCARE
MAY35345OtherBCBS INDIVIDUAL
MAGO-Y49204Medicare UPIN
MA001-872OtherTUFTS HEALTH PLAN