Provider Demographics
NPI:1578625927
Name:STEUBEN CHIROPRACTIC ASSOCIATES PC
Entity Type:Organization
Organization Name:STEUBEN CHIROPRACTIC ASSOCIATES PC
Other - Org Name:CORNING CHIROPRACTIC ASSOC
Other - Org Type:Other Name
Authorized Official - Title/Position:DC OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:V
Authorized Official - Last Name:NICASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:607-962-3387
Mailing Address - Street 1:75 W PULTENEY ST
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:NY
Mailing Address - Zip Code:14830
Mailing Address - Country:US
Mailing Address - Phone:607-962-3387
Mailing Address - Fax:607-937-3674
Practice Address - Street 1:75 W PULTENEY ST
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-2252
Practice Address - Country:US
Practice Address - Phone:607-962-3387
Practice Address - Fax:607-937-3674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1578625927OtherBLUE CROSS BLUE SHIELD
NY1578625927OtherTODAY'S OPTIONS
NY1578625927OtherLANDMARK
NY1578625927OtherEMBLEM
NY1578625927OtherUNITED HEALTHCARE
NY1578625927OtherAETNA
NY1578625927OtherELMCO
NY1578625927OtherRMSCO
NY1578625927OtherFIDELIS
NY1578625927OtherEMPIRE
NY1578625927OtherPOMCO
AA0017Medicare PIN