Provider Demographics
NPI:1124193032
Name:PRZYBYLAK, JOHN FRANCIS (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FRANCIS
Last Name:PRZYBYLAK
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 1:4017 HARLEM RD
Mailing Address - Street 2:
Mailing Address - City:SNYDER
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4707
Mailing Address - Country:US
Mailing Address - Phone:716-839-5100
Mailing Address - Fax:716-839-5186
Practice Address - Street 1:4017 HARLEM RD
Practice Address - Street 2:
Practice Address - City:SNYDER
Practice Address - State:NY
Practice Address - Zip Code:14226-4707
Practice Address - Country:US
Practice Address - Phone:716-839-5100
Practice Address - Fax:716-839-5186
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007727111N00000X, 111NN1001X, 111NR0200X, 111NT0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NR0200XChiropractic ProvidersChiropractorRadiology
No111NT0100XChiropractic ProvidersChiropractorThermography
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11325BMedicare PIN