Provider Demographics
NPI:1033370465
Name:MAURO, DEAN ANTHONY (DC)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:ANTHONY
Last Name:MAURO
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 1:72- 15 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-1525
Mailing Address - Country:US
Mailing Address - Phone:917-697-3117
Mailing Address - Fax:
Practice Address - Street 1:7215 GRAND AVE
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-1525
Practice Address - Country:US
Practice Address - Phone:917-697-3117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007184111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor