MEDICARE: DR. PHILIP J CILIO DC, LAC

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	111NN0400X	Neurology Chiropractor	007720	NY

General Provider Information

NPI Number	:	1609950443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP J CILIO DC, LAC

Provider Business Mailing Address
First Line	:	1757 MERRICK AVE
Second Line	:	SUITE 100
City	:	MERRICK
State	:	NY
Zip	:	11566-2717
Country	:	US
Telephone Number	:	516-474-9585
Fax Number	:	516-826-1461

Provider Business Practice Location Address
First Line	:	1757 MERRICK AVE
Second Line	:	SUITE 100
City	:	MERRICK
State	:	NY
Zip	:	11566-2717
Country	:	US
Telephone Number	:	516-474-9585
Fax Number	:	516-826-1461

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

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	01/21/2024

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