Provider Demographics
NPI:1154415081
Name:ORENCIA, CARRIE ANNE (DC)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:ANNE
Last Name:ORENCIA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 HIGBIE LN
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-2828
Mailing Address - Country:US
Mailing Address - Phone:631-650-5399
Mailing Address - Fax:
Practice Address - Street 1:577 MAIN ST
Practice Address - Street 2:
Practice Address - City:ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11751-3528
Practice Address - Country:US
Practice Address - Phone:631-252-1636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010489111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor