Provider Demographics
NPI:1346419512
Name:MICHAEL TUCCIARONE D.C.
Entity Type:Organization
Organization Name:MICHAEL TUCCIARONE D.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TUCCIARONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:315-853-5050
Mailing Address - Street 1:54 DWIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NY
Mailing Address - Zip Code:13323-1604
Mailing Address - Country:US
Mailing Address - Phone:315-853-5050
Mailing Address - Fax:
Practice Address - Street 1:54 DWIGHT AVE
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NY
Practice Address - Zip Code:13323-1604
Practice Address - Country:US
Practice Address - Phone:315-853-5050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0040661111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1269Medicare PIN