Provider Demographics
NPI:1598950933
Name:VISCONTI FAMILY CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:VISCONTI FAMILY CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DION
Authorized Official - Middle Name:A
Authorized Official - Last Name:VISCONTI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:516-797-9200
Mailing Address - Street 1:888 HICKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:N MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-1215
Mailing Address - Country:US
Mailing Address - Phone:516-797-9200
Mailing Address - Fax:516-797-9500
Practice Address - Street 1:888 HICKSVILLE RD
Practice Address - Street 2:
Practice Address - City:N MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-1215
Practice Address - Country:US
Practice Address - Phone:516-797-9200
Practice Address - Fax:516-797-9500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010024-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU-90248Medicare UPIN