Provider Demographics
NPI:1144414475
Name:PAPORTO, ANDREA (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:PAPORTO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 TITUSVILLE RD # A
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-2944
Mailing Address - Country:US
Mailing Address - Phone:845-454-5558
Mailing Address - Fax:845-454-0834
Practice Address - Street 1:316 TITUSVILLE RD # A
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-2944
Practice Address - Country:US
Practice Address - Phone:845-454-5558
Practice Address - Fax:845-454-0834
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY70011392111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
X01941Medicare PIN