Provider Demographics
NPI:1609950443
Name:CILIO, PHILIP J (DC, LAC)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:J
Last Name:CILIO
Suffix:
Gender:M
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1757 MERRICK AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-2717
Mailing Address - Country:US
Mailing Address - Phone:516-474-9585
Mailing Address - Fax:516-826-1461
Practice Address - Street 1:1757 MERRICK AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-2717
Practice Address - Country:US
Practice Address - Phone:516-474-9585
Practice Address - Fax:516-826-1461
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2024-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007720111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU69766Medicare UPIN
NYX3A412Medicare ID - Type Unspecified