Provider Demographics
NPI:1437214996
Name:PINNATA, ROBERT THOMAS JR (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:THOMAS
Last Name:PINNATA
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 PHIPPS LANE
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803
Mailing Address - Country:US
Mailing Address - Phone:516-526-1039
Mailing Address - Fax:516-938-5805
Practice Address - Street 1:43 PHIPPS LANE
Practice Address - Street 2:
Practice Address - City:PLAIN VIEW
Practice Address - State:NY
Practice Address - Zip Code:11803
Practice Address - Country:US
Practice Address - Phone:516-526-1039
Practice Address - Fax:516-938-5805
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010031-1111N00000X
NYX010031111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor