Provider Demographics
NPI:1801005244
Name:DISCOVER CHIROPRACTIC PC
Entity Type:Organization
Organization Name:DISCOVER CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZURKIEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:716-648-3418
Mailing Address - Street 1:229 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-4915
Mailing Address - Country:US
Mailing Address - Phone:716-648-3418
Mailing Address - Fax:716-649-8002
Practice Address - Street 1:229 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-4915
Practice Address - Country:US
Practice Address - Phone:716-648-3418
Practice Address - Fax:716-649-8002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0048131-NY111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty