Healthcare Provider Details

I. General information

NPI: 1316851868
Provider Name (Legal Business Name): DANIEL SHIN CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 N MAIN ST
CASSADAGA NY
14718-9600
US

IV. Provider business mailing address

PO BOX 300
CASSADAGA NY
14718-0300
US

V. Phone/Fax

Practice location:
  • Phone: 716-595-2090
  • Fax: 716-961-2434
Mailing address:
  • Phone: 716-388-3554
  • Fax: 716-961-2434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DANIEL SHIN
Title or Position: PRESIDENT
Credential: DC
Phone: 716-388-3554