1578625927 NPI number — STEUBEN CHIROPRACTIC ASSOCIATES PC

Table of content: (NPI 1578625927)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578625927 NPI number — STEUBEN CHIROPRACTIC ASSOCIATES PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STEUBEN CHIROPRACTIC ASSOCIATES 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:
6
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:
1578625927
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
75 W PULTENEY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORNING
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14830
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
607-962-3387
Provider Business Mailing Address Fax Number:
607-937-3674

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
75 W PULTENEY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORNING
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14830-2252
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-962-3387
Provider Business Practice Location Address Fax Number:
607-937-3674
Provider Enumeration Date:
12/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NICASTRO
Authorized Official First Name:
DENISE
Authorized Official Middle Name:
V
Authorized Official Title or Position:
DC OWNER
Authorized Official Telephone Number:
607-962-3387

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1578625927 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1578625927 . This is a "TODAY'S OPTIONS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1578625927 . This is a "LANDMARK" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1578625927 . This is a "EMBLEM" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1578625927 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1578625927 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1578625927 . This is a "ELMCO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1578625927 . This is a "RMSCO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1578625927 . This is a "FIDELIS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1578625927 . This is a "EMPIRE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1578625927 . This is a "POMCO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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