Provider Demographics
NPI:1891742870
Name:PRINCIPE, SALVATORE R (DC)
Entity Type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:R
Last Name:PRINCIPE
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 1:420 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-1322
Mailing Address - Country:US
Mailing Address - Phone:631-242-7555
Mailing Address - Fax:631-242-7587
Practice Address - Street 1:420 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-1322
Practice Address - Country:US
Practice Address - Phone:631-242-7555
Practice Address - Fax:631-242-7587
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX4382111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT26658Medicare UPIN
NYX4C191Medicare PIN