Provider Demographics
NPI:1932275443
Name:AMHERST FAMILY CHIROPRACTIC CENTER, INC.
Entity Type:Organization
Organization Name:AMHERST FAMILY CHIROPRACTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:C
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DABCO
Authorized Official - Phone:434-944-5913
Mailing Address - Street 1:3 PHEASANT LN
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-6311
Mailing Address - Country:US
Mailing Address - Phone:607-319-0813
Mailing Address - Fax:607-319-0813
Practice Address - Street 1:3 PHEASANT LN
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-6311
Practice Address - Country:US
Practice Address - Phone:607-319-0813
Practice Address - Fax:607-319-0813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000564111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA206642OtherANTHEM
VAC10856OtherMEDICARE GROUP PTAN