MEDICARE: MARIO E INTRONA D C P 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	X0008391	NY

General Provider Information

NPI Number	:	1619133188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARIO E INTRONA D C P C

Provider Business Mailing Address
First Line	:	1523 RICHMOND RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-2313
Country	:	US
Telephone Number	:	914-649-0355
Fax Number	:	845-278-7987

Provider Business Practice Location Address
First Line	:	1523 RICHMOND RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-2313
Country	:	US
Telephone Number	:	914-649-0355
Fax Number	:	845-278-7987

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MARIO E INTRONA
Credential	:	DC
Telephone Number	:	914-649-0355

Provider Enumeration Date	:	08/04/2008
Last Update Date	:	04/30/2024

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Directions to “MARIO E INTRONA D C P C ” Practice Location

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