Provider Demographics
NPI:1013189430
Name:ATLAS CHIROPRACTIC SERVICES, P.C.
Entity Type:Organization
Organization Name:ATLAS CHIROPRACTIC SERVICES, P.C.
Other - Org Name:ATLAS CHIROPRACTIC, P.C.
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIRO ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:POKORNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-463-4641
Mailing Address - Street 1:141 SHOP CITY PLZ
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13206-1943
Mailing Address - Country:US
Mailing Address - Phone:315-414-0224
Mailing Address - Fax:315-414-0396
Practice Address - Street 1:141 SHOP CITY PLZ
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13206-1943
Practice Address - Country:US
Practice Address - Phone:315-414-0224
Practice Address - Fax:315-414-0396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007300-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA1441Medicare PIN