Healthcare Provider Details
I. General information
NPI: 1922197870
Provider Name (Legal Business Name): BUKATY FAMILY CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/11/2006
Last Update Date: 12/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4269 ST. FRANCIS DR
HAMBURG NY
14075
US
IV. Provider business mailing address
4269 ST. FRANCIS DR
HAMBURG NY
14075
US
V. Phone/Fax
- Phone: 716-627-3668
- Fax: 716-627-2332
- Phone: 716-627-3668
- Fax: 716-627-2332
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | X009117-2 |
| License Number State | NY |
VIII. Authorized Official
Name: DR.
CHRISTINA
BUKATY
Title or Position: PRESIDENT/OWNER
Credential: D.C.
Phone: 716-627-3668