Provider Demographics
NPI:1548421530
Name:ADVANCED CARE CHIROPRACTIC OF WNY
Entity Type:Organization
Organization Name:ADVANCED CARE CHIROPRACTIC OF WNY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAPPIA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:716-835-2225
Mailing Address - Street 1:1641 HERTEL AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14216-2905
Mailing Address - Country:US
Mailing Address - Phone:716-835-2225
Mailing Address - Fax:716-835-2260
Practice Address - Street 1:1641 HERTEL AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14216-2905
Practice Address - Country:US
Practice Address - Phone:716-835-2225
Practice Address - Fax:716-835-2260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009433-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA0304Medicare PIN