National Provider Identifier Database

RUSSELL D BROCCOLI, DC – NPI #1689740607
Chiropractor

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.


Contact Information

RUSSELL D BROCCOLI, DC
635 HOPE STREET
PROVIDENCE, RI02906
Phone: 401-351-6390
Fax: 401-331-0614
Website:
Specialty Taxonomy Code
* Chiropractor 111N00000X

* Indicates primary specialty

NPI Profile & details for RUSSELL D BROCCOLI

NPI Number 1689740607
Credentials DC (Doctor of Chiropractic)
Entity Individual
Enumeration date 11/28/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor1 No
Identifiers
  • RI License #: DCP00204
  • RI Other: 90476 BCBS
  • RI Other: 204088 BLUE CHIP
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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