Provider Demographics
NPI:1437345535
Name:DUANE D SCARBOROUGH DC CHIROPRACTIC AND WELLNESS SERVICES, PLLC
Entity Type:Organization
Organization Name:DUANE D SCARBOROUGH DC CHIROPRACTIC AND WELLNESS SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DUANE
Authorized Official - Middle Name:D
Authorized Official - Last Name:SCARBOROUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-343-4427
Mailing Address - Street 1:4831 BATAVIA ELBA TWL RD
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-1077
Mailing Address - Country:US
Mailing Address - Phone:585-343-4427
Mailing Address - Fax:
Practice Address - Street 1:4831 BATAVIA ELBA TWL RD
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-1077
Practice Address - Country:US
Practice Address - Phone:585-343-4427
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT26056Medicare PIN