Provider Demographics
NPI:1770582850
Name:GANA, SHELDON J (DC)
Entity type:Individual
Prefix:DR
First Name:SHELDON
Middle Name:J
Last Name:GANA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-5345
Mailing Address - Country:US
Mailing Address - Phone:508-646-3800
Mailing Address - Fax:508-646-1800
Practice Address - Street 1:407 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-5345
Practice Address - Country:US
Practice Address - Phone:508-646-3800
Practice Address - Fax:508-646-1800
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2409111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY36680OtherBCBS MA
MA11167782OtherCAQH
MAGAY36680Medicare ID - Type Unspecified
MAY36680OtherBCBS MA