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General NPI Number Information
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NPI Number | 1225782618
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Entity Type | Organization
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Legal Business Name | PAUL D PRIOLO DC PC
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Dates
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Enumeration Date | 02/05/2022
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Last Update Date | 02/05/2022
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Provider Practice Location Address
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Address Line | 2805 VETERANS MEMORIAL HWY STE 8
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City | RONKONKOMA
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State | NY
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Zip | 11779-7680
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Country | US
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Telephone | 631-676-6324
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Fax |
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Provider Business Mailing Address
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Address Line | 4 CHAPEL HILL CT
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City | LAKE GROVE
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State | NY
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Zip | 11755-2470
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Country | US
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Telephone | 631-379-2711
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. PAUL DAVID PRIOLO
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Credential | DC
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Telephone | 631-379-2711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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