MEDICARE: CARLA MERCOGLIANO DC

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	009270	NY

General Provider Information

NPI Number	:	1215333190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA MERCOGLIANO DC

Provider Business Mailing Address
First Line	:	5509 MERRICK RD
Second Line	:
City	:	MASSAPEQUA
State	:	NY
Zip	:	11758-6215
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5509 MERRICK RD
Second Line	:
City	:	MASSAPEQUA
State	:	NY
Zip	:	11758-6215
Country	:	US
Telephone Number	:	516-541-8933
Fax Number	:

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

Provider Enumeration Date	:	11/05/2014
Last Update Date	:	11/05/2014

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Directions to “ CARLA MERCOGLIANO DC” Practice Location

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