Provider Demographics
NPI:1164795126
Name:DR. DANIEL A. DISCHIAVO, CHIROPRACTOR, P.C.
Entity Type:Organization
Organization Name:DR. DANIEL A. DISCHIAVO, CHIROPRACTOR, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:DISCHIAVO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:315-732-2200
Mailing Address - Street 1:4299 MIDDLE SETTLEMENT RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-5329
Mailing Address - Country:US
Mailing Address - Phone:315-732-2200
Mailing Address - Fax:315-732-2313
Practice Address - Street 1:4299 MIDDLE SETTLEMENT RD
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-5329
Practice Address - Country:US
Practice Address - Phone:315-732-2200
Practice Address - Fax:315-732-2313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX05947111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU12036Medicare UPIN