Provider Demographics
NPI:1205889268
Name:ANNABEL, ALTON L (DC)
Entity type:Individual
Prefix:DR
First Name:ALTON
Middle Name:L
Last Name:ANNABEL
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 1:252B VAN ETTEN RD
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:NY
Mailing Address - Zip Code:14883-9568
Mailing Address - Country:US
Mailing Address - Phone:607-589-6100
Mailing Address - Fax:
Practice Address - Street 1:252B VAN ETTEN RD
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:NY
Practice Address - Zip Code:14883-9568
Practice Address - Country:US
Practice Address - Phone:607-589-6100
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006950111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBB3205Medicare ID - Type UnspecifiedMEDICARE #