MEDICARE: DR. JULIANA MARIE MARCINIAK D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	012237	NY

General Provider Information

NPI Number	:	1003165762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIANA MARIE MARCINIAK D.C.

Provider Business Mailing Address
First Line	:	173 N SEINE DR
Second Line	:
City	:	CHEEKTOWAGA
State	:	NY
Zip	:	14227-3113
Country	:	US
Telephone Number	:	716-574-9305
Fax Number	:

Provider Business Practice Location Address
First Line	:	2625 DELAWARE AVE STE 102
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14216-1705
Country	:	US
Telephone Number	:	716-335-9711
Fax Number	:	716-335-9696

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2012
Last Update Date	:	10/29/2012

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