Provider Demographics
NPI:1023132164
Name:SIMUNICK, GREG (DC)
Entity type:Individual
Prefix:DR
First Name:GREG
Middle Name:
Last Name:SIMUNICK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-2721
Mailing Address - Country:US
Mailing Address - Phone:412-391-2225
Mailing Address - Fax:412-391-2224
Practice Address - Street 1:606 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-2721
Practice Address - Country:US
Practice Address - Phone:412-391-2225
Practice Address - Fax:412-391-2224
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-007531-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30675Medicare ID - Type Unspecified