Provider Demographics
NPI:1043943384
Name:MONTEMAGNI CHIROPRACTIC PC
Entity type:Organization
Organization Name:MONTEMAGNI CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEDAY-MONTEMAGNI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-533-4186
Mailing Address - Street 1:1C SUFFERN PL
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-5505
Mailing Address - Country:US
Mailing Address - Phone:845-533-4186
Mailing Address - Fax:888-981-2817
Practice Address - Street 1:1C SUFFERN PL
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-5505
Practice Address - Country:US
Practice Address - Phone:845-533-4186
Practice Address - Fax:888-981-2817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty