Provider Demographics
NPI:1942610183
Name:MARCINIAK CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:MARCINIAK CHIROPRACTIC PLLC
Other - Org Name:PEAK PERFORMANCE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIANA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MARCINIAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:716-335-9711
Mailing Address - Street 1:2625 DELAWARE AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14216-1705
Mailing Address - Country:US
Mailing Address - Phone:716-335-9711
Mailing Address - Fax:716-335-9696
Practice Address - Street 1:2625 DELAWARE AVE STE 102
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14216-1705
Practice Address - Country:US
Practice Address - Phone:716-335-9711
Practice Address - Fax:716-335-9696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ300129490Medicare PIN
NYJ300079103Medicare PIN