Northeast Chiropractic Center PA

Primary specialty

Nutrition ChiropractorTaxonomy code 111NN1001X

License

CR739 Issued in ME

Legal business name

NORTHEAST CHIROPRACTIC CENTER PA

Practice address

304 Hancock St
Suite 2G
Bangor, ME 04401-6573

Phone

(207) 990-5711

Fax

(207) 990-5712

NPI assigned

May 16, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. George P De Maertelaere, DC

Title

Dr/Ceo

Phone

(207) 990-5711

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Lynn Lynch, LMT

  • Mechanotherapist
  • Bangor, ME
  • NPI 1811276124
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310083200000",
    "number": "1275825804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 HANCOCK ST",
            "address_2": "2G",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016573",
            "telephone_number": "207-990-5711",
            "fax_number": "207-990-5712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 HANCOCK ST",
            "address_2": "SUITE 2G",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016573",
            "telephone_number": "207-990-5711",
            "fax_number": "207-990-5712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST CHIROPRACTIC CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-16",
        "last_updated": "2011-07-08",
        "status": "A",
        "authorized_official_last_name": "DE MAERTELAERE",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DR/CEO",
        "authorized_official_telephone_number": "207-990-5711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "ME",
            "license": "CR739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122650099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard A Noonan, ACSW, LCSW, LADC,MAC
• Julie Annette Normand, DPT
• Seann Norris, LMSW-CC
• Northeast Cardiology Associates
• Northeast Chiropractic Center
• Northeast Eyecare, Inc.
• Northeast Nephrology PA
• Northeast Neurosurgery, P.a.
• Northeast Occupational Exchange, Inc
• Northeast Oral & Maxillofacial Surgery Associates P.a.

• Nutrition Chiropractor in Bangor, ME
• Providers in Bangor, ME by specialty
• Nutrition Chiropractor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.