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General NPI Number Information
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NPI Number | 1851469027
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Entity Type | Individual
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Provider Name | THOMAS R VENTIMIGLIA D.C.
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Gender | Male
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8838 WOODHAVEN BLVD
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City | WOODHAVEN
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State | NY
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Zip | 11421-2138
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Country | US
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Telephone | 718-847-9888
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Fax |
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Provider Business Mailing Address
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Address Line | 141 ANN ST
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City | VALLEY STREAM
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State | NY
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Zip | 11580-2703
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Country | US
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Telephone | 718-847-9888
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Fax | 516-735-3037
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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 | X002558
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License Number State | NY
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