Provider Demographics
NPI:1992061600
Name:LOUIS J. SPAGNOLA DC PC
Entity type:Organization
Organization Name:LOUIS J. SPAGNOLA DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SPAGNOLA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:845-452-5200
Mailing Address - Street 1:1145 ROUTE 55 STE 4
Mailing Address - Street 2:
Mailing Address - City:LAGRANGEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12540-5047
Mailing Address - Country:US
Mailing Address - Phone:845-452-5200
Mailing Address - Fax:845-483-0824
Practice Address - Street 1:96 DANBURY RD
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4069
Practice Address - Country:US
Practice Address - Phone:845-452-5200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-06
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000737261QH0100X
NYX005054-1261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service