Provider Demographics
NPI:1518149996
Name:PERINTON HILLS CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:PERINTON HILLS CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:CARMELA
Authorized Official - Last Name:ZALONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:585-223-2610
Mailing Address - Street 1:360 PERINTON HILLS OFFICE PARK
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-3607
Mailing Address - Country:US
Mailing Address - Phone:585-223-2610
Mailing Address - Fax:585-223-2646
Practice Address - Street 1:360 PERINTON HILLS OFFICE PARK
Practice Address - Street 2:
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-3607
Practice Address - Country:US
Practice Address - Phone:585-223-2610
Practice Address - Fax:585-223-2646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011169-1111N00000X
NY011237111N00000X
NY009731111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY696207OtherACN
NY9418594OtherPHCS
NY180518 ANOtherPREFERRED CARE
NYC11169-W2OtherWORKER'S COMPENSATION
NY7252739OtherAETNA
NYC11169-W2OtherWORKER'S COMPENSATION
V08549Medicare UPIN