Provider Demographics
NPI:1619927068
Name:PRZYBYLA, DENNIS G (DC)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:G
Last Name:PRZYBYLA
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 1:1796 CLINTON STREET
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14206
Mailing Address - Country:US
Mailing Address - Phone:716-826-1661
Mailing Address - Fax:716-826-6110
Practice Address - Street 1:1796 CLINTON STREET
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14206
Practice Address - Country:US
Practice Address - Phone:716-826-1661
Practice Address - Fax:716-826-6110
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX01819111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
055561Medicare ID - Type Unspecified
U26005Medicare UPIN