Individual
MRS. DIANE JENAVE IWANIEC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
133 COLUMBIA TURNPIKE, RENSSELAER, NY 12144
(518) 432-7951
(518) 432-7421
Mailing address
133 COLUMBIA TURNPIKE, RENSSELAER, NY 12144
(518) 432-7951
(518) 432-7421
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
0104001439
VA
111N00000X
Chiropractor
Primary
X005916
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10066230
CDPHP
NY
01
—
CO5916
WCB
NY
01
—
X5P921
EBCBS
NY
Enumeration date
10/27/2006
Last updated
07/08/2007
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