Provider Demographics
NPI:1669505608
Name:HANNIGAN CHIROPRACTIC PC
Entity Type:Organization
Organization Name:HANNIGAN CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:HANNIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:845-297-6688
Mailing Address - Street 1:11 MARSHALL RD
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-4132
Mailing Address - Country:US
Mailing Address - Phone:845-297-6688
Mailing Address - Fax:845-298-7401
Practice Address - Street 1:11 MARSHALL RD
Practice Address - Street 2:SUITE 2A
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-4132
Practice Address - Country:US
Practice Address - Phone:845-297-6688
Practice Address - Fax:845-298-7401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX3660111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0060116OtherGHI
NY100331OtherPOMCO
NY0060116OtherGHI