Provider Demographics
NPI:1477681963
Name:SANTELL, MARIANNE (DC)
Entity Type:Individual
Prefix:DR
First Name:MARIANNE
Middle Name:
Last Name:SANTELL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MARIANNE
Other - Middle Name:
Other - Last Name:SIMONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1625 ROCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:14425-9633
Mailing Address - Country:US
Mailing Address - Phone:585-869-5120
Mailing Address - Fax:585-869-5121
Practice Address - Street 1:1625 ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NY
Practice Address - Zip Code:14425-9633
Practice Address - Country:US
Practice Address - Phone:585-869-5120
Practice Address - Fax:585-869-5121
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009868-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP010009868OtherEXCELLUS BLUE CHOICE
NY1477681963OtherAETNA
NYP010009868OtherEXCELLUS BCBS
NY1477681963OtherUNITED HEALTH CARE
NYC09868-3BOtherWORK COMP