Provider Demographics
NPI:1407158553
Name:WARREN A. MARRANCA, DC, PC
Entity Type:Organization
Organization Name:WARREN A. MARRANCA, DC, PC
Other - Org Name:NORTHTOWNS CHIROPRACTIC AND PAIN MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:T
Authorized Official - Last Name:HERR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:716-480-5646
Mailing Address - Street 1:1967 WEHRLE DRIVE
Mailing Address - Street 2:SUITE 12
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14221
Mailing Address - Country:US
Mailing Address - Phone:716-204-8955
Mailing Address - Fax:716-204-8958
Practice Address - Street 1:1967 WEHRLE DRIVE
Practice Address - Street 2:SUITE 12
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14221
Practice Address - Country:US
Practice Address - Phone:716-204-8955
Practice Address - Fax:716-204-8958
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WARREN A. MARRANCA, DC, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010065111N00000X
NYX011122111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DD3482Medicare PIN
NYU86562Medicare UPIN