Provider Demographics
NPI:1982654273
Name:LITTMAN, CORY J (DC)
Entity Type:Individual
Prefix:DR
First Name:CORY
Middle Name:J
Last Name:LITTMAN
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 1:828 DAVISON RD
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-5228
Mailing Address - Country:US
Mailing Address - Phone:716-438-1332
Mailing Address - Fax:716-433-3163
Practice Address - Street 1:828 DAVISON RD
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-5228
Practice Address - Country:US
Practice Address - Phone:716-438-1332
Practice Address - Fax:716-433-3163
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008811111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY161543331OtherPRISM
NY8810936OtherINDEPENDENT HEALTH
NY161543331OtherPRISM
NY68784Medicare UPIN