Provider Demographics
NPI:1083238216
Name:ORLANDO, IMMACULATE (CHIROPRACTOR)
Entity Type:Individual
Prefix:DR
First Name:IMMACULATE
Middle Name:
Last Name:ORLANDO
Suffix:
Gender:F
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 PLANDOME RD
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-2303
Mailing Address - Country:US
Mailing Address - Phone:516-388-8960
Mailing Address - Fax:
Practice Address - Street 1:1000 ROYAL CT UNIT 1102
Practice Address - Street 2:
Practice Address - City:NORTH HILLS
Practice Address - State:NY
Practice Address - Zip Code:11040-2618
Practice Address - Country:US
Practice Address - Phone:201-481-1943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008020-01111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor