MEDICARE: DR. ANTHONY VERRILLI D.C.

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	X4494	NY

General Provider Information

NPI Number	:	1558335133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY VERRILLI D.C.

Provider Business Mailing Address
First Line	:	3077 HYLAN BLVD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-4154
Country	:	US
Telephone Number	:	718-987-2408
Fax Number	:	718-987-9240

Provider Business Practice Location Address
First Line	:	3077 HYLAN BLVD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-4154
Country	:	US
Telephone Number	:	718-987-2408
Fax Number	:	718-987-9240

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

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	03/19/2008

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