Provider Demographics
NPI:1821036310
Name:MARK L. DELMONTE DC PC
Entity type:Organization
Organization Name:MARK L. DELMONTE DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONWER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:L
Authorized Official - Last Name:DELMONTE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:716-285-0391
Mailing Address - Street 1:1410 PINE AVE
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301-1922
Mailing Address - Country:US
Mailing Address - Phone:716-285-0391
Mailing Address - Fax:716-528-0392
Practice Address - Street 1:1410 PINE AVE
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-1922
Practice Address - Country:US
Practice Address - Phone:716-285-0391
Practice Address - Fax:716-528-0392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004917111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty