Active NPI
Paul M Vassa, D.C.
- Chiropractor
- Holbrook, NY
National Provider Identifier
1073672929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X008693
- Practice address
- 233 Union Ave
Ste 102
Holbrook, NY 11741-1813 - Phone
- (631) 664-6841
- Fax
- (631) 368-4172
- NPI assigned
- Dec 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X008693 | NY | Primary |
Addresses
Primary practice location
233 Union Ave
Ste 102
Holbrook, NY 11741-1813
Mailing address
12 Hill St
Ronkonkoma, NY 11779-1807
Phone (516) 983-3725
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X008693 | NY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476144000000",
"number": "1073672929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 HILL ST",
"city": "RONKONKOMA",
"state": "NY",
"postal_code": "117791807",
"telephone_number": "516-983-3725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "233 UNION AVE",
"address_2": "STE 102",
"city": "HOLBROOK",
"state": "NY",
"postal_code": "117411813",
"telephone_number": "631-664-6841",
"fax_number": "631-368-4172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VASSA",
"first_name": "PAUL",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-06",
"last_updated": "2016-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X008693",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Holbrook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.