MEDICARE: DR. EVELY JOANNY PACHECO MATIAS DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	X013913	NY

General Provider Information

NPI Number	:	1447056791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EVELY JOANNY PACHECO MATIAS DC

Provider Business Mailing Address
First Line	:	6406 CEDAR CREEK WAY
Second Line	:
City	:	FARMINGTON
State	:	NY
Zip	:	14425-9634
Country	:	US
Telephone Number	:	939-262-2581
Fax Number	:

Provider Business Practice Location Address
First Line	:	6406 CEDAR CREEK WAY
Second Line	:
City	:	FARMINGTON
State	:	NY
Zip	:	14425-9634
Country	:	US
Telephone Number	:	939-262-2581
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2025
Last Update Date	:	07/24/2025

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Directions to “ DR. EVELY JOANNY PACHECO MATIAS DC” Practice Location

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