Provider Demographics
NPI:1558455485
Name:ADIRONDACK FAMILY CHIROPRACTIC PC
Entity Type:Organization
Organization Name:ADIRONDACK FAMILY CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:F
Authorized Official - Last Name:CLAUSS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:518-561-6004
Mailing Address - Street 1:PO BOX 3046
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-0298
Mailing Address - Country:US
Mailing Address - Phone:518-561-6004
Mailing Address - Fax:518-561-0357
Practice Address - Street 1:148 MARGARET ST
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-1838
Practice Address - Country:US
Practice Address - Phone:518-561-6004
Practice Address - Fax:518-561-0357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005051-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT26744Medicare UPIN
NYBA0729Medicare PIN