Provider Demographics
NPI:1043305378
Name:COUNIHAN, DONALD F JR (DC)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:F
Last Name:COUNIHAN
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 FIRST AVENUE
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1105
Mailing Address - Country:US
Mailing Address - Phone:781-895-7900
Mailing Address - Fax:781-290-0720
Practice Address - Street 1:85 FIRST AVENUE
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1105
Practice Address - Country:US
Practice Address - Phone:781-895-7900
Practice Address - Fax:781-290-0720
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3244111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
737530Medicare UPIN
T38372Medicare UPIN