Provider Demographics
NPI:1487623047
Name:SIGILLO CHIROPRACTIC PC
Entity type:Organization
Organization Name:SIGILLO CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SIGILLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:585-637-3630
Mailing Address - Street 1:54 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BROCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14420-1649
Mailing Address - Country:US
Mailing Address - Phone:585-637-3630
Mailing Address - Fax:585-637-3641
Practice Address - Street 1:54 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BROCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14420-1649
Practice Address - Country:US
Practice Address - Phone:585-637-3630
Practice Address - Fax:585-637-3641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-16
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008823111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
605229OtherACN GROUP
5980631OtherAETNA
P030008823OtherBCBS
837807OtherMPN
BA0462OtherMEDICARE PC
010008823OtherBLUE CHOICE
RC70008823OtherRCIPA
000499739002OtherBCBS OF WESTERN NY
106035ANOtherPREFERRED CARE
5897516OtherAETNA
000499739002OtherBCBS OF WESTERN NY
P030008823OtherBCBS
P030008823OtherBCBS
837807OtherMPN