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Individual

DR. LISA A MEGNA VICINANZO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DC

Contact information

Practice address
959 WASHINGTON AVE, ALBANY, NY 12206
(518) 489-4811
(518) 489-6200
Mailing address
959 WASHINGTON AVE, ALBANY, NY 12206
(518) 489-4811
(518) 489-6200

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X0063451
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
X5570
BLUE CROSS BLUE SHIELD
NY
Enumeration date
12/11/2006
Last updated
07/08/2007
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