Provider Demographics
NPI:1033366703
Name:LEROY CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:LEROY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATING MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:SANEWSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:585-768-2890
Mailing Address - Street 1:7133 W MAIN RD
Mailing Address - Street 2:
Mailing Address - City:LE ROY
Mailing Address - State:NY
Mailing Address - Zip Code:14482-9352
Mailing Address - Country:US
Mailing Address - Phone:585-768-2890
Mailing Address - Fax:585-769-2957
Practice Address - Street 1:7133 W MAIN RD
Practice Address - Street 2:
Practice Address - City:LE ROY
Practice Address - State:NY
Practice Address - Zip Code:14482-9352
Practice Address - Country:US
Practice Address - Phone:585-768-2890
Practice Address - Fax:585-769-2957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009184111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPO40019184OtherBC/BS
NY7677315OtherAETNA
NYPO10019184OtherBLUE CHOICE
NY106036ANOtherPREFERRED CARE
NY8813182OtherINDEPENDENT HEALTH
NYCO9184-5BOtherWORKER'S COMP
NYPO10019184OtherBLUE CHOICE
NYPO40019184OtherBC/BS