Organization
NORTH SHORE SPINE & REHAB
Active
Other names
Woburn Family Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHAEL T PENDOLINO D.C. (PRESIDENT/OWNER)
(781) 938-9400
Entity
Organization
Contact information
Practice address
20 CUMMINGS PARK, WOBURN, MA 01801-2122
(781) 938-9400
(781) 938-9323
Mailing address
20 CUMMINGS PARK, WOBURN, MA 01801-2122
(781) 938-9400
(781) 938-9323
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1697021
MASSHEALTH
MA
01
—
2611483
AETNA
MA
01
—
460083
TUFTS
MA
01
—
AA7544
HPHC
MA
01
—
TAX ID
CIGNA
MA
01
—
Y36576
BCBS
MA
01
—
Y39891
BCBS
MA
Enumeration date
11/12/2008
Last updated
11/12/2008
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