Provider Demographics
NPI:1487976890
Name:IACOBELLI, THOMAS KYLE (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:KYLE
Last Name:IACOBELLI
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 1:19 HILLCREST LN
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-8529
Mailing Address - Country:US
Mailing Address - Phone:518-682-2655
Mailing Address - Fax:518-682-2656
Practice Address - Street 1:81 RAILROAD PL
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-2124
Practice Address - Country:US
Practice Address - Phone:518-682-2655
Practice Address - Fax:518-682-2656
Is Sole Proprietor?:No
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011795111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor