Active NPI
Mulak Chiropractic Center Inc
Doing business as CitySide Chiropractic Center
- Chiropractor
- Providence, RI
National Provider Identifier
1316076342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DCP00464
- Legal business name
- MULAK CHIROPRACTIC CENTER INC
- Doing business as
- CitySide Chiropractic Center
- Practice address
- 411 Broadway
Providence, RI 02909 - Phone
- (401) 272-5710
- Fax
- (401) 272-5711
- NPI assigned
- Mar 5, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Mark James Mulak, DC
- Title
- Chiropractic Physician
- Phone
- (401) 272-5710
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DCP00464 | RI | Primary |
Addresses
Primary practice location
411 Broadway
Providence, RI 02909
Mailing address
411 Broadway
Providence, RI 02909
Phone (401) 272-5710
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 648874 | Other | RI | UNITED HEALTH |
| 214665 | Other | RI | BCBS |
| 410060 | Other | RI | BLUE CHIP |
Other names 1
- CitySide Chiropractic Center
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1200009600000",
"number": "1316076342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 BROADWAY",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "02909",
"telephone_number": "401-272-5710",
"fax_number": "401-272-5711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 BROADWAY",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "02909",
"telephone_number": "401-272-5710",
"fax_number": "401-272-5711"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MULAK CHIROPRACTIC CENTER INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-05",
"last_updated": "2008-01-11",
"status": "A",
"authorized_official_last_name": "MULAK",
"authorized_official_first_name": "MARK",
"authorized_official_middle_name": "JAMES",
"authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN",
"authorized_official_telephone_number": "401-272-5710",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DC"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "RI",
"license": "DCP00464",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH",
"identifier": "648874",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "214665",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP",
"identifier": "410060",
"state": "RI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CitySide Chiropractic Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.