Provider Demographics
NPI:1417226564
Name:SCOTT A. VINCI, D.C., P.C.
Entity Type:Organization
Organization Name:SCOTT A. VINCI, D.C., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:VINCI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:631-979-3613
Mailing Address - Street 1:1308 TOWNLINE RD
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2803
Mailing Address - Country:US
Mailing Address - Phone:631-979-3613
Mailing Address - Fax:631-979-2847
Practice Address - Street 1:1308 TOWNLINE RD
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-2803
Practice Address - Country:US
Practice Address - Phone:631-979-3613
Practice Address - Fax:631-979-2847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004870-1111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty