MEDICARE: DONALD LITTLEJOHN II 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	X4365-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4470784	OTHER	NY	AETNA PPO (DR NAME)
2	10086242	OTHER	NY	CDPHP
3	261179200	OTHER	NY	FEDERAL WORKERS' COMP
4	1119494002	OTHER	NY	CIGNA
5	1C3863	OTHER	NY	LANDMARK
6	555513	OTHER	NY	AETNA AUSCH DR. NAME
7	76677	OTHER	NY	AETNA AUSCH OFFICE ID
8	000445141001	OTHER	NY	HEALTHNOW (PRISM)
9	0092949	OTHER	NY	GHI ALIGNIS
10	C04365-5B	OTHER	NY	IME (WC)
11	P746592	OTHER	NY	OXFORD
12	05000436 SNY01	OTHER	NY	ANTHEM HEALTH
13	1513	OTHER	NY	AMHC
14	1C8858	OTHER	NY	PHS
15	22-2695629-01	OTHER	NY	PRISM
16	X004365-N01	OTHER	NY	HIP
17	22-2695629	OTHER	NY	TAX IDENTIFICATION NUMBER
18	X24831	OTHER	NY	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1962401596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD LITTLEJOHN II DC

Provider Business Mailing Address
First Line	:	7 ACADEMY AVE
Second Line	:
City	:	CHESTER
State	:	NY
Zip	:	10918-1041
Country	:	US
Telephone Number	:	845-469-7575
Fax Number	:	845-469-9328

Provider Business Practice Location Address
First Line	:	7 ACADEMY AVE
Second Line	:
City	:	CHESTER
State	:	NY
Zip	:	10918-1041
Country	:	US
Telephone Number	:	845-469-7575
Fax Number	:	845-469-9328

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

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	04/02/2010

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Directions to “ DONALD LITTLEJOHN II DC” Practice Location

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