Provider Demographics
NPI:1932165909
Name:MARCINAK, JAMES W (DC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:MARCINAK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3019 S PARK RD
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1772
Mailing Address - Country:US
Mailing Address - Phone:412-831-2100
Mailing Address - Fax:412-831-2133
Practice Address - Street 1:3019 S PARK RD
Practice Address - Street 2:
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-1772
Practice Address - Country:US
Practice Address - Phone:412-831-2100
Practice Address - Fax:412-831-2133
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005242L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA001770714Medicaid
PAU71572Medicare UPIN
PA013508Medicare ID - Type Unspecified