NPIMap

American Diagnsotic Lab., Inc

Organization Active NPI Rehabilitation Practitioner · Brockton, MA

NPI 1003963273 · NPPES record last updated Jul 3, 2008

Key facts

NPI
1003963273
Entity type
Organization (NPI type 2)
Primary specialty
Rehabilitation Practitioner 225400000X
License
34550 (MA)
Legal business name
AMERICAN DIAGNSOTIC LAB., INC
Practice address
144 Main St
Brockton, MA 02301-4046
Phone
(508) 984-5200
Fax
(508) 996-8614
NPI assigned
Jan 3, 2007
Organization subpart
No

Authorized official

Name
Mrs. Elizabeth C Medeiros
Title
Manager
Phone
(508) 984-5200

Corporate family (same tax ID) 5

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
American Diagnostic Lab Inc (6 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 225400000X 34550 MA Yes

Addresses

Primary practice location

144 Main St
Brockton, MA 02301-4046

Mailing address

144 Main St
Brockton, MA 02301-4046
Phone (508) 984-5200

Other identifiers

IdentifierTypeStateIssuer
AA61439OtherMAHARVARD PILGRIM
34994OtherMANEIGHBORHOOD HEALTH

Other names

  • Feel Well Rehab Clinic Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 3, 2008.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1003963273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014046",
            "telephone_number": "508-984-5200",
            "fax_number": "508-996-8614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014046",
            "telephone_number": "508-984-5200",
            "fax_number": "508-996-8614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN DIAGNSOTIC LAB., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "MEDEIROS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "508-984-5200",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": "MA",
            "license": "34550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA61439",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH",
            "identifier": "34994",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Feel Well Rehab Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brockton, MA

All providers in Brockton, MA · Rehabilitation Practitioner in Massachusetts

Sources for this page

Verify at the official NPI Registry.