MEDICARE: ALAMILLA AND SALZBERG, PC, 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	5928	NY
2	111NN0400X	Neurology Chiropractor	5229	NY

General Provider Information

NPI Number	:	1700064565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALAMILLA AND SALZBERG, PC, DC

Provider Business Mailing Address
First Line	:	16302 NORTHERN BLVD
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11358-2645
Country	:	US
Telephone Number	:	718-353-2225
Fax Number	:	718-353-3227

Provider Business Practice Location Address
First Line	:	16302 NORTHERN BLVD
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11358-2645
Country	:	US
Telephone Number	:	718-353-2225
Fax Number	:	718-353-3227

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SUSAN MIRIAM SALZBERG
Credential	:	D.C.
Telephone Number	:	17183532225

Provider Enumeration Date	:	02/04/2008
Last Update Date	:	02/04/2008

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