Provider Demographics
NPI:1083861058
Name:A. HANSLICK CORP.
Entity type:Organization
Organization Name:A. HANSLICK CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:HANSLICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-331-1801
Mailing Address - Street 1:513 W UNION ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NY
Mailing Address - Zip Code:14513-1365
Mailing Address - Country:US
Mailing Address - Phone:315-331-1801
Mailing Address - Fax:
Practice Address - Street 1:513 W UNION ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NY
Practice Address - Zip Code:14513-1365
Practice Address - Country:US
Practice Address - Phone:315-331-1801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008568-1111N00000X
NYX003266-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty