MEDICARE: JOEL DAVID NEWBURG 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	013031-1	NY

General Provider Information

NPI Number	:	1093292534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOEL DAVID NEWBURG D.C.

Provider Business Mailing Address
First Line	:	PO BOX 70
Second Line	:
City	:	DUNKIRK
State	:	NY
Zip	:	14048-0070
Country	:	US
Telephone Number	:	716-366-2229
Fax Number	:	716-366-7874

Provider Business Practice Location Address
First Line	:	4867 W LAKE RD
Second Line	:
City	:	DUNKIRK
State	:	NY
Zip	:	14048-9613
Country	:	US
Telephone Number	:	716-366-2229
Fax Number	:

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

Provider Enumeration Date	:	07/27/2018
Last Update Date	:	07/27/2018

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