Provider Demographics
NPI:1730214339
Name:PIRRAGLIA, THERESA LUCY (DC)
Entity type:Individual
Prefix:DR
First Name:THERESA
Middle Name:LUCY
Last Name:PIRRAGLIA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 FIFTH AVE
Mailing Address - Street 2:PELHAM HEALING CENTER
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-1251
Mailing Address - Country:US
Mailing Address - Phone:914-738-2696
Mailing Address - Fax:914-738-2465
Practice Address - Street 1:629 FIFTH AVE
Practice Address - Street 2:PELHAM HEALING CENTER
Practice Address - City:PELHAM
Practice Address - State:NY
Practice Address - Zip Code:10803-1251
Practice Address - Country:US
Practice Address - Phone:914-738-2696
Practice Address - Fax:914-738-2465
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010623111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX6T521Medicare ID - Type Unspecified