Provider Demographics
NPI:1790891836
Name:LOVERRO, JOSEPH ANTHONY (DC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ANTHONY
Last Name:LOVERRO
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 1:305 WAITE ROAD
Mailing Address - Street 2:
Mailing Address - City:NICHOLS
Mailing Address - State:NY
Mailing Address - Zip Code:13812
Mailing Address - Country:US
Mailing Address - Phone:607-699-7459
Mailing Address - Fax:
Practice Address - Street 1:OWEGO CHIROPRACTIC, P.C.
Practice Address - Street 2:115 TEMPLE STREET
Practice Address - City:OWEGO
Practice Address - State:NY
Practice Address - Zip Code:13827
Practice Address - Country:US
Practice Address - Phone:607-687-3800
Practice Address - Fax:607-687-6607
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX003968-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
V02482Medicare UPIN
NYCC8695Medicare ID - Type Unspecified