Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 648 | MA |
NPI | 1003899568 |
---|---|
Provider Name | Dr. Eileen Geralyn Cejka |
First Address | Maynard, MA 01754-1360 |
Second Address | Maynard, MA 01754-1360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2005 |
Last Update Date | 27/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1601563 | (05) | MA |
352223 | HARVARD PILGRIM HEALTHPLA (01) | MA |
44-2000 | UNITED HEALTHCARE (01) | MA |
705036 | TUFTS HEALTH PLAN (01) | MA |
T58182 | (02) | MA |
Y35448 | BLUE CROSS BLUE SHIELD ID (01) | MA |