Provider Demographics
NPI:1154305233
Name:ADAMCZUK, IRENE K (DC)
Entity Type:Individual
Prefix:DR
First Name:IRENE
Middle Name:K
Last Name:ADAMCZUK
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 1:1031 TITUS AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-4029
Mailing Address - Country:US
Mailing Address - Phone:585-342-7707
Mailing Address - Fax:
Practice Address - Street 1:1031 TITUS AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14617-4029
Practice Address - Country:US
Practice Address - Phone:585-342-7707
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX2035111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY15060BMedicare ID - Type UnspecifiedPROVIDER NUMBER