Provider Demographics
NPI:1326239211
Name:ONONDAGA HILL CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:ONONDAGA HILL CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DC OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:ANCONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:315-469-7791
Mailing Address - Street 1:4525 WEST SENECA TURNPIKE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13215
Mailing Address - Country:US
Mailing Address - Phone:315-469-7791
Mailing Address - Fax:315-469-4073
Practice Address - Street 1:4525 W SENECA TPKE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13215
Practice Address - Country:US
Practice Address - Phone:315-469-7791
Practice Address - Fax:315-469-4073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007292111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U43277Medicare UPIN
AA0511Medicare PIN