Provider Demographics
NPI:1437356540
Name:WRONA, MICHAEL JOSEPH (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:WRONA
Suffix:
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 1:5373 TRANSIT RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-8550
Mailing Address - Country:US
Mailing Address - Phone:716-688-5377
Mailing Address - Fax:716-688-6080
Practice Address - Street 1:5373 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-8550
Practice Address - Country:US
Practice Address - Phone:716-688-5377
Practice Address - Fax:716-688-6080
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007353111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2230013OtherBCBS OF WESTERN N.Y.
NY007353OtherLICENSE
NYCO-7353-8OtherWORKERS COMP
NY5802186OtherGHI
NYCO-7353-8OtherWORKERS COMP
NYU43028Medicare UPIN