Provider Demographics
NPI:1376013219
Name:SUWAK, NATALIE KAY (DC)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:KAY
Last Name:SUWAK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 NOYES RD
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-5615
Mailing Address - Country:US
Mailing Address - Phone:607-624-0943
Mailing Address - Fax:
Practice Address - Street 1:103 NOYES RD
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-5615
Practice Address - Country:US
Practice Address - Phone:607-624-0943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-04
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013193111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor