Provider Demographics
NPI:1609034321
Name:MARINELLI, SANDRA TEMPLE (DC)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:TEMPLE
Last Name:MARINELLI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 THREE VILLAGE LN
Mailing Address - Street 2:
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-1319
Mailing Address - Country:US
Mailing Address - Phone:631-246-5858
Mailing Address - Fax:631-751-3695
Practice Address - Street 1:6 THREE VILLAGE LN
Practice Address - Street 2:
Practice Address - City:SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-1319
Practice Address - Country:US
Practice Address - Phone:631-246-5858
Practice Address - Fax:631-751-3695
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX003533-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor