Provider Demographics
NPI:1841244464
Name:DAVIDOFF, STACY R (DC)
Entity Type:Individual
Prefix:DR
First Name:STACY
Middle Name:R
Last Name:DAVIDOFF
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 1:12 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLIFTON SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:14432
Mailing Address - Country:US
Mailing Address - Phone:315-462-2225
Mailing Address - Fax:315-462-7972
Practice Address - Street 1:12 E MAIN ST
Practice Address - Street 2:CLIFTON SPRINGS CHIROPRACTIC
Practice Address - City:CLIFTON SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:14432
Practice Address - Country:US
Practice Address - Phone:315-462-2225
Practice Address - Fax:315-462-7972
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0075211111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY100243ANOtherPREFERRED CARE
NY100243ANOtherPREFERRED CARE
U46578Medicare UPIN