Provider Demographics
NPI:1568640233
Name:MACRONE, JOHN H (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:MACRONE
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 1:2839 BELL BLVD
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-2541
Mailing Address - Country:US
Mailing Address - Phone:718-631-3344
Mailing Address - Fax:
Practice Address - Street 1:2839 BELL BLVD
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-2541
Practice Address - Country:US
Practice Address - Phone:718-631-3344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005147-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY103092700OtherDOL/OWCP
NY961932835Medicare PIN