Provider Demographics
NPI:1073733010
Name:SIDERIS, JAMES CHRISTOPHER (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CHRISTOPHER
Last Name:SIDERIS
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 1:1874 ROUTE 52
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-3502
Mailing Address - Country:US
Mailing Address - Phone:845-896-0717
Mailing Address - Fax:845-896-3002
Practice Address - Street 1:1874 ROUTE 52
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-3502
Practice Address - Country:US
Practice Address - Phone:845-896-0717
Practice Address - Fax:845-896-3002
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006303-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX62081Medicare UPIN