MEDICARE: AMODEO CHIROPRACTIC PC

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	261QH0100X	Health Service Clinic/Center	X004576-7	NY

General Provider Information

NPI Number	:	1942463922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMODEO CHIROPRACTIC PC

Provider Business Mailing Address
First Line	:	155 ALL ANGELS HILL RD
Second Line	:
City	:	WAPPINGERS FALLS
State	:	NY
Zip	:	12590-3322
Country	:	US
Telephone Number	:	845-298-7105
Fax Number	:	845-298-7138

Provider Business Practice Location Address
First Line	:	155 ALL ANGELS HILL RD
Second Line	:
City	:	WAPPINGERS FALLS
State	:	NY
Zip	:	12590-3322
Country	:	US
Telephone Number	:	845-298-7105
Fax Number	:	845-298-7138

Authorized Official
Title or Position	:	OWNER
Name	:	DR. THOMAS J AMODEO
Credential	:	DC
Telephone Number	:	845-298-7105

Provider Enumeration Date	:	07/09/2008
Last Update Date	:	07/09/2008

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