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General NPI Number Information
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NPI Number | 1033274592
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Entity Type | Individual
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Provider Name | SEAN P TRUJILLO DC
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Gender | Male
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 09/17/2009
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Provider Practice Location Address
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Address Line | 140 BELLE MEAD RD SUITE D
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City | EAST SETAUKET
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State | NY
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Zip | 11733-6400
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Country | US
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Telephone | 631-689-8662
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Fax | 631-689-5916
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Provider Business Mailing Address
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Address Line | PO BOX 351
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City | MOUNT SINAI
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State | NY
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Zip | 11766-0351
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Country | US
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Telephone | 631-689-8662
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Fax | 631-689-5916
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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 | X009294-1
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License Number State | NY
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