Healthcare Provider Details

I. General information

NPI: 1255840542
Provider Name (Legal Business Name): CINQUE CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2017
Last Update Date: 11/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252 UNION ST APT 1
SCHENECTADY NY
12305
US

IV. Provider business mailing address

2791 W LYDIUS ST
SCHENECTADY NY
12306-7006
US

V. Phone/Fax

Practice location:
  • Phone: 518-952-1730
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX013008
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License NumberX013008
License Number StateNY

VIII. Authorized Official

Name: ALEXA CINQUE
Title or Position: OWNER/CHIROPRACTOR
Credential: DC
Phone: 518-952-1730