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NPI Code Detail

MEDICARE: DR. VINCENT PAUL DETRINIS D.C.

MEDICARE:  DR. VINCENT PAUL DETRINIS  D.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
1111N00000XChiropractorX4504NY

General Provider Information

NPI Number : 1710102165
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VINCENT PAUL DETRINIS D.C.
Provider Business Mailing Address
First Line : 3 SAGE RD
Second Line :
City : PORT JEFFERSON STATION
State : NY
Zip : 11776-1817
Country : US
Telephone Number : 631-689-2993
Fax Number :
Provider Business Practice Location Address
First Line : 3 SAGE RD
Second Line :
City : PORT JEFFERSON STATION
State : NY
Zip : 11776-1817
Country : US
Telephone Number : 631-689-2993
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2007
Last Update Date : 02/19/2010

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Directions to “ DR. VINCENT PAUL DETRINIS D.C.” Practice Location

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