Provider Demographics
NPI:1649289547
Name:SCARBOROUGH, PAUL VICTOR (DC)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:VICTOR
Last Name:SCARBOROUGH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:285 LEXINGTON AVE
Mailing Address - Street 2:2 FL.
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2519
Mailing Address - Country:US
Mailing Address - Phone:212-532-3220
Mailing Address - Fax:646-358-5608
Practice Address - Street 1:285 LEXINGTON AVE
Practice Address - Street 2:2 FL.
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3569
Practice Address - Country:US
Practice Address - Phone:212-532-3220
Practice Address - Fax:212-252-2803
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYX009769111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU97325Medicare UPIN