Organization
MICHAEL A. GRUTTADAURIA, CHIROPRACTOR, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GRUTTADAURIA DC (CHIROPRACTOR)
(516) 351-9372
Entity
Organization
Contact information
Practice address
326 WALT WHITMAN RD, HUNTINGTON STATION, NY 11746-8703
(631) 673-1001
Mailing address
19 KENNEDY DR, PLAINVIEW, NY 11803-4017
Taxonomy
Speciality
Code
Description
License number
State
111NN0400X
Neurology Chiropractor
Primary
X005485
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A100101212
PTAN
—
Enumeration date
08/07/2013
Last updated
06/23/2014
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