Individual
DR. NICHOLAS CHARLES BAVARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
422C GREAT EAST NECK RD UNIT C, WEST BABYLON, NY 11704-7610
(917) 748-1139
Mailing address
422 GREAT EAST NECK RD UNIT C, WEST BABYLON, NY 11704-7628
(631) 661-6611
(631) 661-5504
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
X008794
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02090540
—
NY
Enumeration date
10/06/2006
Last updated
03/21/2025
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