Provider Demographics
NPI:1255334108
Name:VASSALLO, FRANK (DC)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:
Last Name:VASSALLO
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 1:193 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-3353
Mailing Address - Country:US
Mailing Address - Phone:315-253-6073
Mailing Address - Fax:315-253-0340
Practice Address - Street 1:193 GENESEE ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-3353
Practice Address - Country:US
Practice Address - Phone:315-253-6073
Practice Address - Fax:315-253-0340
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2756111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY38172BMedicare ID - Type Unspecified