Provider Demographics
NPI:1982799151
Name:SANFILIPO, FRED L (DC)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:L
Last Name:SANFILIPO
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 1:2755 BUFFALO RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-1337
Mailing Address - Country:US
Mailing Address - Phone:585-426-1576
Mailing Address - Fax:585-426-7888
Practice Address - Street 1:2755 BUFFALO RD
Practice Address - Street 2:SUITE D
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-1337
Practice Address - Country:US
Practice Address - Phone:585-426-1576
Practice Address - Fax:585-426-7888
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30058111N00000X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPO10003005OtherBLUE CROSS BLUE SHIELD
PO10003005OtherBLUE CHOICE
NY101859ANOtherPREF CARE
5173481OtherAETNA
5173481OtherAETNA
T26168Medicare UPIN