Provider Demographics
NPI:1881862332
Name:STRAILE CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:STRAILE CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:STRAILE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:315-468-2422
Mailing Address - Street 1:5631 W GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:CAMILLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13031-1324
Mailing Address - Country:US
Mailing Address - Phone:315-468-2422
Mailing Address - Fax:
Practice Address - Street 1:5631 W GENESEE ST
Practice Address - Street 2:
Practice Address - City:CAMILLUS
Practice Address - State:NY
Practice Address - Zip Code:13031-1324
Practice Address - Country:US
Practice Address - Phone:315-468-2422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007894111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX79592Medicare UPIN
NYAA1362Medicare PIN