Provider Demographics
NPI:1356772990
Name:CAMARATA, SAMUEL JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:JOSEPH
Last Name:CAMARATA
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 1:8 HARVEST HL
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-4468
Mailing Address - Country:US
Mailing Address - Phone:585-507-1652
Mailing Address - Fax:
Practice Address - Street 1:8 HARVEST HL
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-4468
Practice Address - Country:US
Practice Address - Phone:585-507-1652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-08
Last Update Date:2013-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012448111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor