Organization Active NPI

Haverford Chiropractic Inc.

  • Chiropractor
  • Wayne, PA
National Provider Identifier
1952592024
Registry record updated Aug 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 002095 L Issued in PA
Legal business name
HAVERFORD CHIROPRACTIC INC.
Practice address
105 N Wayne Ave
Rear
Wayne, PA 19087-3566
Phone
(610) 687-8280
Fax
(610) 687-8103
NPI assigned
Aug 5, 2007
Last updated
Aug 5, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2007

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

Authorized official

Name
Dr. Paul Mychlauk, D.C.
Title
Owner
Phone
(610) 687-8280

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 002095 L PA Primary

Addresses

Primary practice location

105 N Wayne Ave
Rear
Wayne, PA 19087-3566

Mailing address

105 N Wayne Ave
Rear
Wayne, PA 19087-3566
Phone (610) 687-8280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161026000225 PA Part B Supplier - Clinic/Group Practice 2365720349 Receives reassigned benefits from 1 practitioner
Practice locations: Wayne, PA

National Provider Directory

National Provider Directory

Locations

105 N Wayne Ave
Rear
Wayne, PA 19087
Phone (610) 687-8280

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186272000000",
    "number": "1952592024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 N WAYNE AVE",
            "address_2": "REAR",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190873566",
            "telephone_number": "610-687-8280",
            "fax_number": "610-687-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N WAYNE AVE",
            "address_2": "REAR",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190873566",
            "telephone_number": "610-687-8280",
            "fax_number": "610-687-8103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVERFORD CHIROPRACTIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "status": "A",
        "authorized_official_last_name": "MYCHLAUK",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-687-8280",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC 002095 L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.