Provider Demographics
NPI:1508171067
Name:CAROL ANN MALIZIA, DC PC
Entity Type:Organization
Organization Name:CAROL ANN MALIZIA, DC PC
Other - Org Name:CHIROPRACTIC HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MALIZIA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:845-567-9190
Mailing Address - Street 1:254 ROUTE 17K
Mailing Address - Street 2:SUITE 304
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-8343
Mailing Address - Country:US
Mailing Address - Phone:845-567-9190
Mailing Address - Fax:845-567-9197
Practice Address - Street 1:254 ROUTE 17K
Practice Address - Street 2:SUITE 304
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-8343
Practice Address - Country:US
Practice Address - Phone:845-567-9190
Practice Address - Fax:845-567-9197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005970-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty