Provider Demographics
NPI:1881666196
Name:SGROI, GARY (DC)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:
Last Name:SGROI
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 1:3944 MERRICK RD
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-2826
Mailing Address - Country:US
Mailing Address - Phone:516-783-3000
Mailing Address - Fax:516-783-3008
Practice Address - Street 1:3944 MERRICK RD
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-2826
Practice Address - Country:US
Practice Address - Phone:516-783-3000
Practice Address - Fax:516-783-3008
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006105111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT92476Medicare UPIN
NYX44661Medicare ID - Type Unspecified