Provider Demographics
NPI:1679782858
Name:SIENKIEWYCZ, NICHOLAS AUGUST (DC)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:AUGUST
Last Name:SIENKIEWYCZ
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 1:3450 WINTON PL
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-2805
Mailing Address - Country:US
Mailing Address - Phone:585-334-4060
Mailing Address - Fax:585-413-0489
Practice Address - Street 1:3450 WINTON PL
Practice Address - Street 2:SUITE 4
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-2805
Practice Address - Country:US
Practice Address - Phone:585-334-4060
Practice Address - Fax:585-413-0489
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011417-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor