Provider Demographics
NPI:1336284926
Name:BIALECKI, JOHN MATTHEW (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MATTHEW
Last Name:BIALECKI
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 1:3140 SHERIDAN DR STE 140
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1900
Mailing Address - Country:US
Mailing Address - Phone:716-240-9365
Mailing Address - Fax:716-240-9368
Practice Address - Street 1:3140 SHERIDAN DR STE 140
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1900
Practice Address - Country:US
Practice Address - Phone:716-240-9365
Practice Address - Fax:716-240-9368
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2021-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYC11365-6B111NI0013X
NY11365111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY8814346OtherINDEPENDENT HEALTH
NYC11365-6BOtherWORKERS' COMPENSATION
NYC11365-6BOtherWORKERS' COMPENSATION