PURE CHIROPRACTIC LLC (NPI# 1194854760) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194854760 |
| Entity Type | Organization |
| Organization Name | PURE CHIROPRACTIC LLC |
| Practice Address |
671 Old Town Rd Port Jefferson Station NY 11776-4200 |
| Mailing Address |
Po Box 810 East Setauket NY 11733-0620 |
| Practice Telephone | 6316422388 |
| Mailing Telephone | 6316422388 |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. SEAN TRUJILLO (VICE PRESIDENT) |
| Authorized Official Telephone | 6316422388 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699290908 | Pure Chiropractic LLC | Chiropractor | 1546a 75th St, Downers Grove, IL 60516-6205 | 2017-08-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | PURE CHIROPRACTIC LLC | 1320 Stony Brook Rd, Suite 26, Stony Brook, Ny 11733 |
| Street Address |
671 OLD TOWN RD |
| City | PORT JEFFERSON STATION |
| State | NY |
| Zip Code | 11776-4200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942638234 | Mary Barto | Specialist | 671 Old Town Rd, Port Jefferson Station, NY 11776-4200 | 2013-10-23 |
| 1184807968 | Thomas Anthony Fiordalisi | Chiropractor | 671 Old Town Rd, Port Jefferson Station, NY 11776-4200 | 2007-12-14 |
| 1518148089 | Core Chiropractic Rehabilitation PC | Chiropractor | 671 Old Town Rd, Port Jefferson Station, NY 11776-4200 | 2007-11-26 |
| 1790814333 | Complete Chiropractic Reabilitation of Port Jefferson Station LLC | Chiropractor | 671 Old Town Rd, Port Jefferson Station, NY 11776-4200 | 2007-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205304219 | Melissa E Germano | Acupuncturist | 5225 Nesconset Highway Rte 347, Davis Professional Park Building 1 Suite 1, Port Jefferson Station, NY 11776 | 2018-11-07 |
| 1366962185 | Michael Louis Scicchitano Sr. | Physical Therapist | 3 Colgate Street, Port Jefferson Station, NY 11776 | 2017-06-22 |
| 1063969517 | Dana Adamkiewicz | Acupuncturist | 432 North Bicycle Path, Port Jefferson Station, NY 11776 | 2016-09-01 |
| 1538531819 | Jacqueline Rambo | Specialist | 5225 Nesconset Highway Suite 30, Port Jefferson Station, NY 11776 | 2015-10-26 |
| 1821474297 | Michael Leuci | Social Worker | 3 Premier Court, Port Jefferson Station, NY 11776 | 2015-08-07 |
| 1578978078 | Carol A. Palmer I | Acupuncturist | 34 Champlain St, Port Jefferson Station, NY 11776 | 2014-06-24 |
| 1659783371 | Janette M Sperandeo | Nurse Practitioner | 5 Roosevelt Avenue, Port Jefferson Station, NY 11776 | 2014-05-29 |
| 1578973079 | James Buchrieser | Specialist | 525 Nesconset Highway Suite 30, Port Jefferson Station, NY 11776 | 2014-05-06 |
| 1871923227 | Duran Thomas Murphy | Licensed Practical Nurse | 8 Carolyn Road, Port Jefferson Station, NY 11776 | 2013-11-22 |
| 1699104562 | Julio Genao | Massage Therapist | 213 Jayne Blvd, Portjefferson Station, NY 11776 | 2013-11-01 |
| Find all providers in zip 11776 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114363041 | In Motion Chiropractic, P.C. | Chiropractor | 59 Dorothy St, Port Jefferson Station, NY 11776-1722 | 2013-05-19 |
| 1194934042 | Lisa Ann Lepore | Chiropractor | 18 Andover Dr, Port Jefferson Station, NY 11776-3014 | 2007-05-21 |
| 1710102165 | Vincent Paul Detrinis | Chiropractor | 3 Sage Rd, Port Jefferson Station, NY 11776-1817 | 2007-04-13 |
| 1891838538 | Chiropractic of Stony Brook Pllc | Chiropractor | 1041 Rout 112, Port Jefferson Station, NY 11776 | 2007-02-14 |
| 1841374352 | Gregory N. Bonasera | Chiropractor | 1041 Route 112, Port Jefferson Station, NY 11776-6000 | 2006-10-24 |
| 1104916998 | Paul David Ravener | Chiropractor | 298 Canal Rd., Port Jefferson Station, NY 11776-3020 | 2006-10-13 |
| 1790890580 | Gary P Dibenedetto | Chiropractor | 298 Canal Rd, Port Jefferson Station, NY 11776 | 2006-08-20 |
| 1407865686 | Sophia Anne Argeropoulos | Chiropractor | 9 Roosevelt Ave, Port Jefferson Station, NY 11776-3336 | 2006-08-05 |
| 1235308172 | Sophia Vivian Lin | Chiropractor | 379 Old Town Rd, Port Jefferson Station, NY 11776-2245 | 2008-02-25 |
| 1184807968 | Thomas Anthony Fiordalisi | Chiropractor | 671 Old Town Rd, Port Jefferson Station, NY 11776-4200 | 2007-12-14 |
| Find all providers in PORT JEFFERSON STATION | ||||
| City | PORT JEFFERSON STATION |
| Zip Code | 11776 |
Please comment or provide details below to improve the information on PURE CHIROPRACTIC LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.