Provider Demographics
NPI:1710042338
Name:TERRIZZI, JOHN MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
Last Name:TERRIZZI
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:PO BOX 4735
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-0735
Mailing Address - Country:US
Mailing Address - Phone:845-565-6007
Mailing Address - Fax:845-565-7372
Practice Address - Street 1:195 WINDSOR HYWAY
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-4735
Practice Address - Country:US
Practice Address - Phone:845-565-6007
Practice Address - Fax:845-565-7372
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX3128111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX24321Medicare ID - Type Unspecified