Provider Demographics
NPI:1295833283
Name:KRATOVILLE, STEVEN G (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:G
Last Name:KRATOVILLE
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 1:1406 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:NY
Mailing Address - Zip Code:14103-1822
Mailing Address - Country:US
Mailing Address - Phone:585-798-0328
Mailing Address - Fax:585-798-0342
Practice Address - Street 1:1406 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:NY
Practice Address - Zip Code:14103-1822
Practice Address - Country:US
Practice Address - Phone:585-798-0328
Practice Address - Fax:585-798-0342
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006401-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000225548001OtherBC/BS OF WNY
NYC06401-6OtherWORKERS COMP
NY106040ANOtherPREFERRED CARE
NY161565796OtherPRISM NETWORKS
GA350054612OtherMEDICARE RR RET BOARD
NY8810832OtherINDEPENDENT HEALTH
NY7229214OtherAETNA
NYP010006401OtherBC/BS OF ROCHESTER
NYC06401-6OtherWORKERS COMP