Healthcare Provider Details

I. General information

NPI: 1295007425
Provider Name (Legal Business Name): UNIONDALE CHIROPRACTIC OFFICE,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2012
Last Update Date: 02/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

482 UNIONDALE AVE
UNIONDALE NY
11553-2201
US

IV. Provider business mailing address

482 UNIONDALE AVE
UNIONDALE NY
11553-2201
US

V. Phone/Fax

Practice location:
  • Phone: 516-485-0220
  • Fax: 516-485-0253
Mailing address:
  • Phone: 516-485-0220
  • Fax: 516-485-0253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX005870-1
License Number StateNY

VIII. Authorized Official

Name: DR. FRANK VITO AMATULLI
Title or Position: PRESIDENT/OWNER
Credential: D.C.
Phone: 516-485-0220