Provider Demographics
NPI:1336282110
Name:PAZOS, DENNIS J (DC LAC)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:J
Last Name:PAZOS
Suffix:
Gender:M
Credentials:DC LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1399 BELLMORE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-5534
Mailing Address - Country:US
Mailing Address - Phone:516-785-5669
Mailing Address - Fax:
Practice Address - Street 1:9616 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11421-2209
Practice Address - Country:US
Practice Address - Phone:718-846-5182
Practice Address - Fax:718-846-7999
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX001973-3111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY94487Medicare ID - Type Unspecified