Provider Demographics
NPI:1861577405
Name:SANFILIPPO, ROBERT J (DC)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:J
Last Name:SANFILIPPO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:26 SOUTH GREELEY AVENUE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:CHAPPAQUE
Mailing Address - State:NY
Mailing Address - Zip Code:10514
Mailing Address - Country:US
Mailing Address - Phone:914-479-1000
Mailing Address - Fax:914-479-0105
Practice Address - Street 1:26 SOUTH GREELEY AVENUE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CHAPPAQUA
Practice Address - State:NY
Practice Address - Zip Code:10514
Practice Address - Country:US
Practice Address - Phone:914-479-1000
Practice Address - Fax:914-479-0105
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008696-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY470851716Medicare UPIN