| NPI | 1104097393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY STEPHEN MANDRACCHIA Owner 718-605-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NY x009001) |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2009-04-28 |