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General NPI Number Information
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NPI Number | 1427128628
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Entity Type | Organization
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Legal Business Name | BARDONIA CHIROPRACTIC OFFICE, PLLC
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 28 BARDONIA RD
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City | BARDONIA
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State | NY
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Zip | 10954-2123
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Country | US
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Telephone | 845-623-1558
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Fax | 845-623-6437
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Provider Business Mailing Address
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Address Line | 28 BARDONIA RD
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City | BARDONIA
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State | NY
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Zip | 10954-2123
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Country | US
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Telephone | 845-623-1558
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Fax | 845-623-6437
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL MICHAEL LENTINI
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Credential | D.C.
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Telephone | 845-623-1558
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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 | X007536
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License Number State | NY
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