Individual
DR. ANTHONY STEPHEN MANDRACCHIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
6659 AMBOY RD, STATEN ISLAND, NY 10309-3125
(718) 605-2225
(718) 966-5630
Mailing address
6659 AMBOY RD, STATEN ISLAND, NY 10309-3125
(718) 605-2225
(718) 966-5630
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X009001
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02044728
—
NY
01
—
2032523
UNITED HEALTHCARE
NY
01
—
X1024
BCBS
NY
Enumeration date
09/17/2006
Last updated
07/24/2023
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