Provider Demographics
NPI:1700922366
Name:BYRNE, JEFFREY A (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:BYRNE
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 1:4692 DRUIDS GLN
Mailing Address - Street 2:
Mailing Address - City:MANLIUS
Mailing Address - State:NY
Mailing Address - Zip Code:13104-8432
Mailing Address - Country:US
Mailing Address - Phone:315-682-2718
Mailing Address - Fax:315-699-2302
Practice Address - Street 1:6253 ROUTE 31
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:NY
Practice Address - Zip Code:13104
Practice Address - Country:US
Practice Address - Phone:315-699-2219
Practice Address - Fax:315-699-2302
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007911111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11530BMedicare UPIN