Individual
DR. GARY GASPER DIFATTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
113 A SOUTH WELLWOOD AVENUE, LINDENHURST, NY 11757
(631) 225-7630
(631) 225-7653
Mailing address
113 A SOUTH WELLWOOD AVENUE, LINDENHURST, NY 11757
(631) 225-7630
(631) 225-7653
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X06832-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11-3168353
TAX ID
NY
Enumeration date
10/18/2006
Last updated
07/08/2007
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