Provider Demographics
NPI:1720178627
Name:IALACCI-PFEIFER, BARBARA A (DC)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:A
Last Name:IALACCI-PFEIFER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:881 HAWKINS AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE GROVE
Mailing Address - State:NY
Mailing Address - Zip Code:11755-1601
Mailing Address - Country:US
Mailing Address - Phone:631-588-3388
Mailing Address - Fax:631-588-5968
Practice Address - Street 1:881 HAWKINS AVE
Practice Address - Street 2:
Practice Address - City:LAKE GROVE
Practice Address - State:NY
Practice Address - Zip Code:11755-1601
Practice Address - Country:US
Practice Address - Phone:631-588-3388
Practice Address - Fax:631-588-5968
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006497111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U37162Medicare UPIN
NYX49381Medicare PIN