Provider Demographics
NPI:1770671794
Name:MORGANTE, THERESA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:THERESA
Middle Name:MARIE
Last Name:MORGANTE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 KENSINGTON AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-1437
Mailing Address - Country:US
Mailing Address - Phone:716-833-2960
Mailing Address - Fax:716-833-4615
Practice Address - Street 1:1660 KENSINGTON AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-1437
Practice Address - Country:US
Practice Address - Phone:716-833-2960
Practice Address - Fax:716-833-4615
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008939-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU71188Medicare UPIN
NYBB1500Medicare ID - Type Unspecified