Provider Demographics
NPI:1932184363
Name:PEPITONE, EMANUEL J (DC)
Entity Type:Individual
Prefix:DR
First Name:EMANUEL
Middle Name:J
Last Name:PEPITONE
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 1:271 NASSAU BLVD S
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-5313
Mailing Address - Country:US
Mailing Address - Phone:631-300-8817
Mailing Address - Fax:516-538-3222
Practice Address - Street 1:271 NASSAU BLVD S
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-5313
Practice Address - Country:US
Practice Address - Phone:631-300-8817
Practice Address - Fax:516-538-3222
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX04176111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX22511Medicare ID - Type Unspecified