Provider Demographics
NPI:1033361688
Name:CARNES, MICHAEL PETER (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PETER
Last Name:CARNES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 ROUTE 25A
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-2648
Mailing Address - Country:US
Mailing Address - Phone:631-849-1586
Mailing Address - Fax:631-849-1587
Practice Address - Street 1:595 ROUTE 25A
Practice Address - Street 2:SUITE 2B
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-2648
Practice Address - Country:US
Practice Address - Phone:631-849-1586
Practice Address - Fax:631-849-1587
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011590-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor