Provider Demographics
NPI:1003809278
Name:NUNZIATA, VINCENT (RN, DC, CDN)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
Last Name:NUNZIATA
Suffix:
Gender:M
Credentials:RN, DC, CDN
Other - Prefix:DR
Other - First Name:MICHEAL
Other - Middle Name:
Other - Last Name:AUSIELLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BS, DC, CTN
Mailing Address - Street 1:6419 BAY PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-3930
Mailing Address - Country:US
Mailing Address - Phone:718-331-2667
Mailing Address - Fax:718-331-9709
Practice Address - Street 1:6419 BAY PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-3930
Practice Address - Country:US
Practice Address - Phone:718-331-2667
Practice Address - Fax:718-331-9709
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-23
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0044821111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX24631Medicare PIN
NYT52813Medicare UPIN