Provider Demographics
NPI:1821051913
Name:SAMMIS, HAROLD KENT III (DC)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:KENT
Last Name:SAMMIS
Suffix:III
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 1:735 SHORE AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:TICONDEROGA
Mailing Address - State:NY
Mailing Address - Zip Code:12883-2809
Mailing Address - Country:US
Mailing Address - Phone:518-585-3509
Mailing Address - Fax:518-585-2225
Practice Address - Street 1:1845 STREET ROAD
Practice Address - Street 2:
Practice Address - City:TICONDEROGA
Practice Address - State:NY
Practice Address - Zip Code:12883-3018
Practice Address - Country:US
Practice Address - Phone:518-585-3509
Practice Address - Fax:518-585-2225
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004489-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY141696150-01OtherPRISM
NY5803893OtherGHI
NYC04489-3BOtherWORKERS COMP
NY000445024001OtherBLUE SHEILD
NY3049OtherAMERICAN MAIL HANDLERS
NYPO10004489OtherBC/BS UW
NYX31161 HSOtherBCBS
NY5803893OtherGHI