Provider Demographics
NPI:1750453189
Name:MESSINA, MARIANNE (DC)
Entity type:Individual
Prefix:DR
First Name:MARIANNE
Middle Name:
Last Name:MESSINA
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 1:172 CAMPBELL RD
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-1810
Mailing Address - Country:US
Mailing Address - Phone:914-962-7993
Mailing Address - Fax:
Practice Address - Street 1:2050 SAW MILL RIVER RD
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-4143
Practice Address - Country:US
Practice Address - Phone:914-962-0100
Practice Address - Fax:914-962-0105
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004790-2111N00000X
NJ38MC00637100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX27321Medicare ID - Type Unspecified