Provider Demographics
NPI:1437133212
Name:ROCHESTER CHIROPRACTIC GROUP, LLP
Entity Type:Organization
Organization Name:ROCHESTER CHIROPRACTIC GROUP, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:VENTURA
Authorized Official - Suffix:
Authorized Official - Credentials:DC,DABCO
Authorized Official - Phone:585-227-7720
Mailing Address - Street 1:1687 ENGLISH RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14616-1609
Mailing Address - Country:US
Mailing Address - Phone:585-227-7720
Mailing Address - Fax:585-227-7858
Practice Address - Street 1:1687 ENGLISH RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14616-1609
Practice Address - Country:US
Practice Address - Phone:585-227-7720
Practice Address - Fax:585-227-7858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003549111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC08856-9Medicare UPIN
NYT26193Medicare UPIN
NYX011060Medicare UPIN
NYT26209Medicare UPIN
NYU65563Medicare UPIN