Provider Demographics
NPI:1740405570
Name:CHIAPPETTA, ANDREA (DC CHIROPRACTOR)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:CHIAPPETTA
Suffix:
Gender:F
Credentials:DC CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2083 EAST 64TH STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234
Mailing Address - Country:US
Mailing Address - Phone:718-444-6364
Mailing Address - Fax:718-209-5102
Practice Address - Street 1:2083 EAST 64TH STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234
Practice Address - Country:US
Practice Address - Phone:718-444-6364
Practice Address - Fax:718-209-5102
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0086001111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
X5V271Medicare ID - Type Unspecified
U94727Medicare UPIN