Healthcare Provider Details

I. General information

NPI: 1669469169
Provider Name (Legal Business Name): NICHOLAS GEORGE SCHAMBERGER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/30/2005
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

535 GREENLEAF MDWS
ROCHESTER NY
14612-4440
US

V. Phone/Fax

Practice location:
  • Phone: 585-663-4574
  • Fax:
Mailing address:
  • Phone: 585-865-0556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX010999
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: