1487623047 NPI number — SIGILLO CHIROPRACTIC PC

Table of content: (NPI 1487623047)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487623047 NPI number — SIGILLO CHIROPRACTIC PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SIGILLO CHIROPRACTIC PC
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:
1487623047
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/13/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
54 N MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROCKPORT
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14420-1649
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-637-3630
Provider Business Mailing Address Fax Number:
585-637-3641

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
54 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROCKPORT
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14420-1649
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-637-3630
Provider Business Practice Location Address Fax Number:
585-637-3641
Provider Enumeration Date:
03/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SIGILLO
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
JOSEPH
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
585-637-3630

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  X008823 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 605229 . This is a "ACN GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5980631 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: P030008823 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 837807 . This is a "MPN" identifier . This identifiers is of the category "OTHER".
  • Identifier: BA0462 . This is a "MEDICARE PC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010008823 . This is a "BLUE CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: RC70008823 . This is a "RCIPA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000499739002 . This is a "BCBS OF WESTERN NY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 106035AN . This is a "PREFERRED CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5897516 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




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