Organization
LIVE WELL CHIROPRACTIC OF MASSAPEQUA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RENEE BOCCIO DC (PRESIDENT)
(516) 316-2032
Entity
Organization
Contact information
Practice address
2466 N JERUSALEM RD, NORTH BELLMORE, NY 11710-1107
(516) 316-2032
(352) 353-4717
Mailing address
2745 RUBY ROSE LN, SAINT CLOUD, FL 34771-9345
(516) 316-2032
(352) 353-4717
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X010111
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C101115W
WORKERS COMPENSATION
NY
Enumeration date
04/16/2008
Last updated
10/01/2024
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