Provider Demographics
NPI:1124123575
Name:CENK CHIROPRACTIC AR ALEXANDERS
Entity type:Organization
Organization Name:CENK CHIROPRACTIC AR ALEXANDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:CENK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-967-9767
Mailing Address - Street 1:1331 FREEPORT RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-3126
Mailing Address - Country:US
Mailing Address - Phone:412-967-9767
Mailing Address - Fax:
Practice Address - Street 1:2585 FREEPORT RD
Practice Address - Street 2:SUITE #106
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-1425
Practice Address - Country:US
Practice Address - Phone:412-828-4430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENK CHIROPRACTIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-13
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004960L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01908423Medicaid
PA001412481OtherOTHER
PA01908423Medicaid