Provider Demographics
NPI:1457943169
Name:FRACZEK-SYCZYK, MATTHEW ALEXANDER (DC, MSACN)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ALEXANDER
Last Name:FRACZEK-SYCZYK
Suffix:
Gender:M
Credentials:DC, MSACN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9102 ROMAINE RD
Mailing Address - Street 2:
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047-5412
Mailing Address - Country:US
Mailing Address - Phone:845-616-6988
Mailing Address - Fax:
Practice Address - Street 1:2 CHELSEA PL
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-3227
Practice Address - Country:US
Practice Address - Phone:518-373-6545
Practice Address - Fax:518-373-1769
Is Sole Proprietor?:No
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013443111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor