Provider Demographics
NPI:1225536899
Name:CARRANZA, JOSEPH (DC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:CARRANZA
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 1:100 BANKS AVE APT 1323
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-6212
Mailing Address - Country:US
Mailing Address - Phone:516-672-8297
Mailing Address - Fax:
Practice Address - Street 1:100 BANKS AVE APT 1323
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-6212
Practice Address - Country:US
Practice Address - Phone:516-672-8297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-29
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX013061111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor