MEDICARE: DR. MICHAEL ALEXANDER CARDUCCI 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	X10633	NY

General Provider Information

NPI Number	:	1497899066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL ALEXANDER CARDUCCI D.C.

Provider Business Mailing Address
First Line	:	28 MARINE AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-6752
Country	:	US
Telephone Number	:	347-578-4408
Fax Number	:	718-627-9338

Provider Business Practice Location Address
First Line	:	825 AVENUE W
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-5558
Country	:	US
Telephone Number	:	718-336-1810
Fax Number	:	718-627-9338

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

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	07/08/2007

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