Organization
DECESARE CHIROPRACTIC OFFICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK W DECASARE DC (OWNER)
(845) 339-6000
Entity
Organization
Contact information
Practice address
572 ULSTER AVE, KINGSTON, NY 12401-1924
(845) 339-6000
(845) 339-6065
Mailing address
572 ULSTER AVE, KINGSTON, NY 12401-1924
(845) 339-6000
(845) 339-6065
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X004697
NY
111N00000X
Chiropractor
X006381
NY
111N00000X
Chiropractor
X008548
NY
111N00000X
Chiropractor
X008697
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5803085
GHI
NY
Enumeration date
12/28/2006
Last updated
01/19/2010
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