Provider Demographics
NPI:1962514216
Name:MCDADE, MARC D (DC)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:D
Last Name:MCDADE
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 1:160 ALLENS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-3309
Mailing Address - Country:US
Mailing Address - Phone:585-241-9990
Mailing Address - Fax:
Practice Address - Street 1:160 ALLENS CREEK RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-3309
Practice Address - Country:US
Practice Address - Phone:585-241-9990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009314-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY665053OtherUNITED HEALTH CARE
NYP010009314OtherBC/BS
NY7726572OtherAETNA