Provider Demographics
NPI:1194946715
Name:SINISGALLI, LORI (DC)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:
Last Name:SINISGALLI
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:PO BOX 293
Mailing Address - Street 2:
Mailing Address - City:BRODHEADSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18322-0293
Mailing Address - Country:US
Mailing Address - Phone:570-730-3556
Mailing Address - Fax:
Practice Address - Street 1:107 KINSLEY DR
Practice Address - Street 2:
Practice Address - City:BRODHEADSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18322-7800
Practice Address - Country:US
Practice Address - Phone:570-402-2810
Practice Address - Fax:570-402-2811
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007446L111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA031876Medicare ID - Type Unspecified