Provider Demographics
NPI:1366458101
Name:WALENTIN CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:WALENTIN CHIROPRACTIC, P.C.
Other - Org Name:COMMUNITY WELLNESS & CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MANOY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:845-534-9331
Mailing Address - Street 1:16 QUAKER AVE
Mailing Address - Street 2:
Mailing Address - City:CORNWALL
Mailing Address - State:NY
Mailing Address - Zip Code:12518-2113
Mailing Address - Country:US
Mailing Address - Phone:845-534-9331
Mailing Address - Fax:845-534-7854
Practice Address - Street 1:16 QUAKER AVE
Practice Address - Street 2:
Practice Address - City:CORNWALL
Practice Address - State:NY
Practice Address - Zip Code:12518-2113
Practice Address - Country:US
Practice Address - Phone:845-534-9331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011024111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10071122OtherCDPHP
NY7140870OtherCIGNA
NY917178OtherAETNA
NYC081564OtherWORKERS COMPENSATION
NY514930OtherPHCS
NY84881OtherGHI HMO
NY0111208OtherGHI
NY101226OtherLOCAL 825
NYU61583Medicare UPIN
NYX70951Medicare ID - Type Unspecified
NYX09Q61OtherEMPIRE BC/BS