Provider Demographics
NPI:1851510309
Name:GRAHAM CHIROPRACTIC INC.
Entity type:Organization
Organization Name:GRAHAM CHIROPRACTIC INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PISZEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-942-9429
Mailing Address - Street 1:44 2ND STREET PIKE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-3830
Mailing Address - Country:US
Mailing Address - Phone:215-942-9429
Mailing Address - Fax:215-942-9432
Practice Address - Street 1:44 2ND STREET PIKE
Practice Address - Street 2:SUITE 202
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-3830
Practice Address - Country:US
Practice Address - Phone:215-942-9429
Practice Address - Fax:215-942-9432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007235L111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1676244OtherHIGHMARK GROUP #
PA2214742Medicare UPIN
PW2214751Medicare UPIN
PA184303Medicare UPIN
PA0781798000Medicare UPIN
PW184349Medicare UPIN
PA1676244OtherHIGHMARK GROUP #
PA066793Medicare ID - Type UnspecifiedDR. LANDIS MEDICARE #
PA035546Medicare ID - Type UnspecifiedDR. PISZEL MEDICARE #