Provider Demographics
NPI:1619143435
Name:SENIW CHIROPRACTIC OFFICE, PC
Entity Type:Organization
Organization Name:SENIW CHIROPRACTIC OFFICE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SENIW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:845-794-6655
Mailing Address - Street 1:433 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:NY
Mailing Address - Zip Code:12701-1722
Mailing Address - Country:US
Mailing Address - Phone:845-794-6655
Mailing Address - Fax:845-794-6701
Practice Address - Street 1:433 BROADWAY
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701-1722
Practice Address - Country:US
Practice Address - Phone:845-794-6655
Practice Address - Fax:845-794-6701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYC3048111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX17351Medicare PIN