Active NPI
Joseph Fazzolari, DC
- Chiropractor
- Woburn, MA
National Provider Identifier
1962142190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3768
- Practice address
- 100 Tradecenter Drive
Suite 725
Woburn, MA 01801 - Phone
- (781) 305-4308
- NPI assigned
- Mar 29, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3768 | MA | Primary |
Addresses
Primary practice location
100 Tradecenter Drive
Suite 725
Woburn, MA 01801
Mailing address
6 Powderkeg Way
Saugus, MA 01906-1494
Phone (781) 799-2103
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3768 | MA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648512000000",
"number": "1962142190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 POWDERKEG WAY",
"city": "SAUGUS",
"state": "MA",
"postal_code": "019061494",
"telephone_number": "781-799-2103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 TRADECENTER DRIVE",
"address_2": "SUITE 725",
"city": "WOBURN",
"state": "MA",
"postal_code": "01801",
"telephone_number": "781-305-4308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAZZOLARI",
"first_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-29",
"last_updated": "2022-03-29",
"certification_date": "2022-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MA",
"license": "3768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woburn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.