Provider Demographics
NPI:1174788087
Name:MICHAEL SANTIPADRI, DC PLLC
Entity type:Organization
Organization Name:MICHAEL SANTIPADRI, DC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CAREY
Authorized Official - Last Name:SANTIPADRI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:617-335-3319
Mailing Address - Street 1:135 CLARENDON ST
Mailing Address - Street 2:UNIT 4F
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-5274
Mailing Address - Country:US
Mailing Address - Phone:617-335-3319
Mailing Address - Fax:
Practice Address - Street 1:437 BOYLSTON ST
Practice Address - Street 2:5TH FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-3307
Practice Address - Country:US
Practice Address - Phone:617-335-3319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2861111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAUX4629Medicare PIN
MAV00764Medicare UPIN