Mark Chudy, DC

Individual provider Active NPI Chiropractor · Wethersfield, CT

NPI 1699831602 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1699831602
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
001296 (CT)
Practice address
82 86 Wolcott Hill Rd
Suite 1
Wethersfield, CT 06109
Phone
(860) 296-4446
Fax
(860) 296-0041
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Chiropractic
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

88 New Britain Ave
Rocky Hill, CT 06067-5101
Phone (860) 436-5446

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20120214000217 CT Practitioner - Chiropractic 1254598626 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Chudy Chiropractic Center LLC Chiropractor Current
since Apr 16, 2016
Accepting new patients
Carbone Chiropractic Center LLC Chiropractor Past
since Oct 1, 2012
Accepting new patients

Locations

88 New Britain Ave
Rocky Hill, CT 06067
Phone (860) 436-5446

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 001296 CT Yes

Addresses

Primary practice location

82 86 Wolcott Hill Rd
Suite 1
Wethersfield, CT 06109

Mailing address

82 86 Wolcott Hill Rd
Suite 1
Wethersfield, CT 06109
Phone (860) 296-4446

Other providers in Wethersfield, CT

All providers in Wethersfield, CT · Chiropractor in Connecticut

Sources for this page

Verify at the official NPI Registry.