Provider Demographics
NPI:1467528893
Name:CORREGANO, JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:CORREGANO
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 1:200 W 57TH ST STE 909
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-3211
Mailing Address - Country:US
Mailing Address - Phone:212-873-0907
Mailing Address - Fax:646-669-7308
Practice Address - Street 1:200 W 57TH ST STE 909
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3211
Practice Address - Country:US
Practice Address - Phone:212-873-0907
Practice Address - Fax:646-669-7308
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008849-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX8AO41Medicare ID - Type Unspecified
NYU70669Medicare UPIN