Provider Demographics
NPI:1619059326
Name:GUIGLOTTO, MICHAEL CHARLES (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CHARLES
Last Name:GUIGLOTTO
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 1:614 N ELTING CORNERS RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12528-2825
Mailing Address - Country:US
Mailing Address - Phone:845-883-6501
Mailing Address - Fax:845-883-6501
Practice Address - Street 1:614 N ELTING CORNERS RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:NY
Practice Address - Zip Code:12528-2825
Practice Address - Country:US
Practice Address - Phone:845-883-6501
Practice Address - Fax:845-883-6501
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009260111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY98L1045OtherMVP PROVIDER #
NY98L1045OtherMVP PROVIDER #