Active NPI
Phyllis M Dellacroce, DC
- Chiropractor
- Mechanicville, NY
National Provider Identifier
1083704779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1728
- Practice address
- 505 Park Ave
Mechanicville, NY 12118 - Phone
- (518) 664-3961
- Fax
- (518) 664-3961
- NPI assigned
- Oct 13, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 1728 | NY | Primary |
Addresses
Primary practice location
505 Park Ave
Mechanicville, NY 12118
Mailing address
505 Park Ave
Mechanicville, NY 12118
Phone (518) 664-3961
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1728 | NY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083704779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 PARK AVE",
"city": "MECHANICVILLE",
"state": "NY",
"postal_code": "12118",
"telephone_number": "518-664-3961",
"fax_number": "518-664-3961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 PARK AVE",
"city": "MECHANICVILLE",
"state": "NY",
"postal_code": "12118",
"telephone_number": "518-664-3961",
"fax_number": "518-664-3961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELLACROCE",
"first_name": "PHYLLIS",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "1728",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mechanicville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.