Provider Demographics
NPI:1588743850
Name:VISCONTI, DION ANDREW (DC)
Entity type:Individual
Prefix:DR
First Name:DION
Middle Name:ANDREW
Last Name:VISCONTI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:888 HICKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:N MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-1215
Mailing Address - Country:US
Mailing Address - Phone:516-797-9200
Mailing Address - Fax:516-797-9500
Practice Address - Street 1:888 HICKSVILLE RD
Practice Address - Street 2:
Practice Address - City:N MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-1215
Practice Address - Country:US
Practice Address - Phone:516-797-9200
Practice Address - Fax:516-797-9500
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010024111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU91248Medicare UPIN
NYX5G691Medicare ID - Type Unspecified