1306044698 NPI number — PYNE CHIROPRACTIC, P.A.

Table of content: DR. MICHAEL R. OBOLENSKY PH.D. (NPI 1891740841)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306044698 NPI number — PYNE CHIROPRACTIC, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PYNE CHIROPRACTIC, P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306044698
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
65 BRYAN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
REHOBOTH BEACH
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19971-9732
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-644-1792
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17252 N VILLAGE MAIN BLVD
Provider Second Line Business Practice Location Address:
SUITE #14-16
Provider Business Practice Location Address City Name:
LEWES
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19958-6292
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-644-1792
Provider Business Practice Location Address Fax Number:
302-644-1793
Provider Enumeration Date:
07/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PYNE
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
MATTHEW
Authorized Official Title or Position:
CHIROPRACTOR
Authorized Official Telephone Number:
302-644-1792

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  F1-000572 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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