Provider Demographics
NPI:1891974200
Name:KATE PACINELLI
Entity Type:Organization
Organization Name:KATE PACINELLI
Other - Org Name:KATIE CONWAY DC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DC
Authorized Official - Prefix:
Authorized Official - First Name:KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:PACINELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:631-425-2600
Mailing Address - Street 1:PO BOX 960
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-0813
Mailing Address - Country:US
Mailing Address - Phone:631-425-2600
Mailing Address - Fax:631-425-3098
Practice Address - Street 1:46 GERARD ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-6944
Practice Address - Country:US
Practice Address - Phone:631-425-2600
Practice Address - Fax:631-425-3098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty