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General NPI Number Information
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NPI Number | 1003561036
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Entity Type | Individual
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Provider Name | MICHAEL THOMAS FUCCI DC
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Gender | Male
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Dates
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Enumeration Date | 02/17/2022
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Last Update Date | 05/18/2022
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Provider Practice Location Address
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Address Line | 146A MANETTO HILL RD STE 106
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City | PLAINVIEW
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State | NY
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Zip | 11803-1323
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Country | US
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Telephone | 516-390-8770
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Fax |
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Provider Business Mailing Address
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Address Line | 90 CEDAR DR W
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City | PLAINVIEW
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State | NY
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Zip | 11803-2824
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X013539
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License Number State | NY
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