Healthcare Provider Details

I. General information

NPI: 1861576613
Provider Name (Legal Business Name): TINA SACCHETTI D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 06/27/2008
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 NumberXOO4751
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: