Provider Demographics
NPI:1962448753
Name:ANKEN, STUART WARREN (DC)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:WARREN
Last Name:ANKEN
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 1:7864 TURIN RD
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440
Mailing Address - Country:US
Mailing Address - Phone:315-337-9240
Mailing Address - Fax:315-336-0744
Practice Address - Street 1:7864 TURIN RD
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440
Practice Address - Country:US
Practice Address - Phone:315-337-9240
Practice Address - Fax:315-336-0744
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYC0000111111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWCC000119OtherWORKERS COMP
35725BMedicare ID - Type Unspecified
NYWCC000119OtherWORKERS COMP