Provider Demographics
NPI:1871612366
Name:HAFNER, CAROL JANE (DC)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:JANE
Last Name:HAFNER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:ADAMS
Mailing Address - State:NY
Mailing Address - Zip Code:13605-1128
Mailing Address - Country:US
Mailing Address - Phone:315-232-2850
Mailing Address - Fax:315-232-2850
Practice Address - Street 1:16 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:ADAMS
Practice Address - State:NY
Practice Address - Zip Code:13605-1128
Practice Address - Country:US
Practice Address - Phone:315-232-2850
Practice Address - Fax:315-232-2850
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009979111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCC7536Medicare ID - Type Unspecified