Provider Demographics
NPI:1508896978
Name:DRAGONETTE, JAMES JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JOSEPH
Last Name:DRAGONETTE
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 1:4735 SOUTHWESTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-1926
Mailing Address - Country:US
Mailing Address - Phone:716-648-6161
Mailing Address - Fax:716-648-4881
Practice Address - Street 1:4735 SOUTHWESTERN BLVD
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-1926
Practice Address - Country:US
Practice Address - Phone:716-648-6161
Practice Address - Fax:716-648-4881
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005326111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2038651OtherBLUE CROSS & BLUE SHIELD
NY5040505OtherAETNA
NYC05326-6BOtherWORKER'S COMPENSATION BOA
NY0030888OtherGHI
NY8809031OtherINDEPENDENT HEALTH
NYC05326-6BOtherWORKER'S COMPENSATION BOA
NY5040505OtherAETNA