1578625927 NPI number — STEUBEN CHIROPRACTIC ASSOCIATES PC

Table of content: ADA ROSE EDWARDS NP (NPI 1053869073)

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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