Provider Demographics
NPI:1548202674
Name:CONNECTICUT FAMILY CHIROPRACTIC CORPORATION PC
Entity Type:Organization
Organization Name:CONNECTICUT FAMILY CHIROPRACTIC CORPORATION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:SCLAFANI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-778-2225
Mailing Address - Street 1:132 FEDERAL ROAD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811
Mailing Address - Country:US
Mailing Address - Phone:203-778-2225
Mailing Address - Fax:203-778-0591
Practice Address - Street 1:132 FEDERAL RD
Practice Address - Street 2:SUITE 103
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-4047
Practice Address - Country:US
Practice Address - Phone:203-778-2225
Practice Address - Fax:203-778-0591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC01543Medicare PIN