Michael Anthony Persoleo Jr., D.C.

Primary specialty

Nutrition ChiropractorTaxonomy code 111NN1001X

License

X012117-1 Issued in NY

Practice address

208 N Meadow St
Ithaca, NY 14850-4027

Phone

(607) 272-0006

NPI assigned

Jan 3, 2012

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Chiropractic Associates of Ithaca

  • Chiropractor
  • Ithaca, NY
  • NPI 1265790034
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1629348941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3A2 CANDLEWYCK PARK",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501320",
            "telephone_number": "607-272-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 N MEADOW ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148504027",
            "telephone_number": "607-272-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSOLEO",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-03",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "NY",
            "license": "X012117-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Perez, MSW
• Judith Ann Perkins, RN
• Matthew Perkins
• Suzanne Marie Perreault, LCSW
• Michele M Perry
• Kate Pesci
• Peter Schwartz, MD, PLLC
• Pamela Peterman, RN
• Brianna Peters, PT, DPT
• Katie Peters

• Nutrition Chiropractor in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Nutrition Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.