MEDICARE: DR. DENNIS G PRZYBYLA 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	X01819	NY

General Provider Information

NPI Number	:	1619927068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS G PRZYBYLA DC

Provider Business Mailing Address
First Line	:	1796 CLINTON STREET
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14206
Country	:	US
Telephone Number	:	716-826-1661
Fax Number	:	716-826-6110

Provider Business Practice Location Address
First Line	:	1796 CLINTON STREET
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14206
Country	:	US
Telephone Number	:	716-826-1661
Fax Number	:	716-826-6110

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

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	07/08/2007

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