=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457472573
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SEAWAY CHIROPRACTIC, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/03/2007
-----------------------------------------------------
Last Update Date | 09/04/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 235 MAIN ST
-----------------------------------------------------
City | MASSENA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13662-1927
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-764-7600
-----------------------------------------------------
Fax | 315-764-7601
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 235 MAIN ST
-----------------------------------------------------
City | MASSENA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13662-1927
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-764-7600
-----------------------------------------------------
Fax | 315-764-7601
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. ANGELA M RUFA
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 315-764-7600
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111NI0013X
-----------------------------------------------------
Taxonomy Name | Independent Medical Examiner Chiropractor
-----------------------------------------------------
License Number | 007286
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------