Active NPI
Stuart A Ezrin, DC
- Chiropractor
- Waban, MA
National Provider Identifier
1972605442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1333
- Practice address
- 1464 Beacon St
Waban, MA 02468-1613 - Phone
- (617) 969-0166
- NPI assigned
- Sep 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 1333 | MA | Primary |
Addresses
Primary practice location
1464 Beacon St
Waban, MA 02468-1613
Mailing address
1464 Beacon St
Waban, MA 02468-1613
Phone (617) 969-0166
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 |
|---|---|---|---|
| 1333 | MA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1972605442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1464 BEACON ST",
"city": "WABAN",
"state": "MA",
"postal_code": "024681613",
"telephone_number": "617-969-0166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1464 BEACON ST",
"city": "WABAN",
"state": "MA",
"postal_code": "024681613",
"telephone_number": "617-969-0166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EZRIN",
"first_name": "STUART",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-03",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MA",
"license": "1333",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waban, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.