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General NPI Number Information
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NPI Number | 1831231760
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Entity Type | Organization
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Legal Business Name | NEWFANE FAMILY CHIROPRACTIC, PC
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 08/04/2008
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Provider Practice Location Address
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Address Line | 2733 MAIN ST
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City | NEWFANE
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State | NY
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Zip | 14108-1203
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Country | US
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Telephone | 716-778-9282
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Fax | 716-778-6742
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Provider Business Mailing Address
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Address Line | 2733 SOUTH MAIN ST.
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City | NEWFANE
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State | NY
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Zip | 14108
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Country | US
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Telephone | 716-778-9282
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Fax | 716-778-6742
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JOHN AND REGINA SYRACUSE
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Credential | DC
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Telephone | 716-778-9282
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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 | X0091601
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X0084131
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License Number State | NY
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