MEDICARE: DR. MICHAEL VANCHIERI 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	012978	NY

General Provider Information

NPI Number	:	1518473479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL VANCHIERI DC

Provider Business Mailing Address
First Line	:	4454 AUSTIN BLVD
Second Line	:
City	:	ISLAND PARK
State	:	NY
Zip	:	11558-1621
Country	:	US
Telephone Number	:	630-567-7718
Fax Number	:

Provider Business Practice Location Address
First Line	:	4454 AUSTIN BOULEVARD
Second Line	:
City	:	ISLAND PARK
State	:	NY
Zip	:	11558-1155
Country	:	US
Telephone Number	:	630-567-7718
Fax Number	:	630-567-7718

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

Provider Enumeration Date	:	12/14/2017
Last Update Date	:	12/14/2017

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