Healthcare Provider Details

I. General information

NPI: 1386710846
Provider Name (Legal Business Name): DAVID ANTHONY SMALDONE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: SMALDONE CHIROPRACTIC PLLC GROUPNPI: 1336606680

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 ALBANY AVE
KINGSTON NY
12401-2141
US

IV. Provider business mailing address

502 ALBANY AVE
KINGSTON NY
12401-2141
US

V. Phone/Fax

Practice location:
  • Phone: 845-338-8404
  • Fax: 845-201-0124
Mailing address:
  • Phone: 845-338-8404
  • Fax: 845-201-0124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX011297
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberX011297
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License NumberX011297
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: