Provider Demographics
NPI:1285853150
Name:FRANCISCO VAQUERO DC PC
Entity Type:Organization
Organization Name:FRANCISCO VAQUERO DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:VAQUERO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:716-248-2825
Mailing Address - Street 1:455 NIAGARA ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14201-1834
Mailing Address - Country:US
Mailing Address - Phone:716-248-2825
Mailing Address - Fax:716-248-2826
Practice Address - Street 1:455 NIAGARA ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14201-1834
Practice Address - Country:US
Practice Address - Phone:716-248-2825
Practice Address - Fax:716-248-2826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008148111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA694947OtherACN GROUP
GAU60972Medicare UPIN
GA35ZCHCBMedicare ID - Type Unspecified