Provider Demographics
NPI:1992864284
Name:SARACENO, DONATO (DC)
Entity Type:Individual
Prefix:
First Name:DONATO
Middle Name:
Last Name:SARACENO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:DAN
Other - Middle Name:
Other - Last Name:SARACENO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:1175 WALT WHITMAN RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-3030
Mailing Address - Country:US
Mailing Address - Phone:631-351-5373
Mailing Address - Fax:631-351-5374
Practice Address - Street 1:1175 WALT WHITMAN RD
Practice Address - Street 2:SUITE 104
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-3030
Practice Address - Country:US
Practice Address - Phone:631-351-5373
Practice Address - Fax:631-351-5374
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX4388111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
X26251Medicare ID - Type Unspecified