Provider Demographics
NPI:1629391537
Name:GUY SIRAKI
Entity type:Organization
Organization Name:GUY SIRAKI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:GUY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIRAKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-967-8666
Mailing Address - Street 1:4 MARGRAFF CT
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-1953
Mailing Address - Country:US
Mailing Address - Phone:201-967-8666
Mailing Address - Fax:
Practice Address - Street 1:4 MARGRAFF CT
Practice Address - Street 2:
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-1953
Practice Address - Country:US
Practice Address - Phone:201-967-8666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-05
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty