MEDICARE: MARCINIAK CHIROPRACTIC PLLC

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

General Provider Information

NPI Number	:	1942610183
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARCINIAK CHIROPRACTIC PLLC

Provider Business Mailing Address
First Line	:	2625 DELAWARE AVE STE 102
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14216-1705
Country	:	US
Telephone Number	:	716-335-9711
Fax Number	:	716-335-9696

Provider Business Practice Location Address
First Line	:	2625 DELAWARE AVE STE 102
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14216-1705
Country	:	US
Telephone Number	:	716-335-9711
Fax Number	:	716-335-9696

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JULIANA MARIE MARCINIAK
Credential	:	D.C.
Telephone Number	:	716-335-9711

Provider Enumeration Date	:	04/28/2014
Last Update Date	:	04/28/2014

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