Provider Demographics
NPI:1205804044
Name:GUERNSEY, MICHAEL C (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:C
Last Name:GUERNSEY
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 1:675 PANORAMA TRL STE 5
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2406
Mailing Address - Country:US
Mailing Address - Phone:585-383-0420
Mailing Address - Fax:800-581-7735
Practice Address - Street 1:675 PANORAMA TRL
Practice Address - Street 2:SUITE #5
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2406
Practice Address - Country:US
Practice Address - Phone:585-383-0420
Practice Address - Fax:800-581-7735
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007163-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC07163-1OtherWORKER'S COMP
NYP010007163OtherBLUE CROSS/BLUE SHIELD
NYP010007163OtherBLUE CHOICE
NY101874ANOtherPREFERRED CARE
NY5686699OtherAETNA
NYU40545Medicare UPIN
NY101874ANOtherPREFERRED CARE