Healthcare Provider Details

I. General information

NPI: 1194778720
Provider Name (Legal Business Name): MERIDIAN CHIROPRACTIC & WELLNESS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 02/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5112 W TAFT RD SUITE 1B
LIVERPOOL NY
13088-4868
US

IV. Provider business mailing address

5112 W TAFT RD SUITE 1B
LIVERPOOL NY
13088-4868
US

V. Phone/Fax

Practice location:
  • Phone: 315-452-9420
  • Fax:
Mailing address:
  • Phone: 315-452-9420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberX010016-1
License Number StateNY

VIII. Authorized Official

Name: DR. ELAINA A PIRRO-LOMBARDI
Title or Position: PRESIDENT
Credential: DO
Phone: 315-452-9420