MEDICARE: DR. NICHOLAS GEORGE SCHAMBERGER 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	X010999	NY

General Provider Information

NPI Number	:	1669469169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICHOLAS GEORGE SCHAMBERGER DC

Provider Business Mailing Address
First Line	:	535 GREENLEAF MDWS
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14612-4440
Country	:	US
Telephone Number	:	585-865-0556
Fax Number	:

Provider Business Practice Location Address
First Line	:	3973 DEWEY AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14616-2530
Country	:	US
Telephone Number	:	585-663-4574
Fax Number	:

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

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	07/08/2007

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