Healthcare Provider Details

I. General information

NPI: 1669602041
Provider Name (Legal Business Name): MAZURKIEWICZ FAMILY CHIROPRACTIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2009
Last Update Date: 07/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 WASHINGTON AVE
BATAVIA NY
14020-2009
US

IV. Provider business mailing address

10 WASHINGTON AVE
BATAVIA NY
14020-2009
US

V. Phone/Fax

Practice location:
  • Phone: 585-343-9316
  • Fax: 585-344-7031
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX002921-1
License Number StateNY

VIII. Authorized Official

Name: DR. THOMAS M MAZURKIEWICZ
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 585-343-9316