Provider Demographics
NPI:1922197870
Name:BUKATY FAMILY CHIROPRACTIC PC
Entity Type:Organization
Organization Name:BUKATY FAMILY CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUKATY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:716-627-3668
Mailing Address - Street 1:4269 ST. FRANCIS DR
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075
Mailing Address - Country:US
Mailing Address - Phone:716-627-3668
Mailing Address - Fax:716-627-2332
Practice Address - Street 1:4269 ST. FRANCIS DR
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075
Practice Address - Country:US
Practice Address - Phone:716-627-3668
Practice Address - Fax:716-627-2332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009117-2111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA1682Medicare UPIN
NYU70091Medicare UPIN