Healthcare Provider Details

I. General information

NPI: 1659402337
Provider Name (Legal Business Name): CHIROPACTIC & WELLNESS CARE, PLLC,
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

879 COMMERCE ST
THORNWOOD NY
10594-1415
US

IV. Provider business mailing address

879 COMMERCE ST
THORNWOOD NY
10594-1415
US

V. Phone/Fax

Practice location:
  • Phone: 914-747-9200
  • Fax: 914-747-4406
Mailing address:
  • Phone: 914-747-9200
  • Fax: 914-747-4406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX004751-6
License Number StateNY

VIII. Authorized Official

Name: DR. TINA SACCHETTI
Title or Position: OWNER
Credential: D.C.
Phone: 914-747-9200