Healthcare Provider Details

I. General information

NPI: 1285622472
Provider Name (Legal Business Name): HEINZ LEO SCHAMBERGER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3973 DEWEY AVE
ROCHESTER NY
14616-2530
US

IV. Provider business mailing address

3973 DEWEY AVE
ROCHESTER NY
14616-2530
US

V. Phone/Fax

Practice location:
  • Phone: 585-663-4874
  • Fax: 585-865-9541
Mailing address:
  • Phone: 585-663-4874
  • Fax: 585-865-9541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX02750
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: