MEDICARE: DR. ROBERT JOSEPH JAWORSKI 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
1	111N00000X	Chiropractor	006600	NY

General Provider Information

NPI Number	:	1841408895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT JOSEPH JAWORSKI D.C.

Provider Business Mailing Address
First Line	:	451 S MAIN ST
Second Line	:
City	:	NORTH SYRACUSE
State	:	NY
Zip	:	13212-2811
Country	:	US
Telephone Number	:	315-458-3100
Fax Number	:	315-458-1031

Provider Business Practice Location Address
First Line	:	451 S MAIN ST
Second Line	:
City	:	NORTH SYRACUSE
State	:	NY
Zip	:	13212-2811
Country	:	US
Telephone Number	:	315-458-3100
Fax Number	:	315-458-1031

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

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	07/08/2007

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