Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | X012486-1 | NY |
NPI | 1003322124 |
---|---|
Provider Name | Jennifer Sperrazza |
First Address | Buffalo, NY 14208-1602 |
Second Address | Buffalo, NY 14208-1602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2017 |
Last Update Date | 27/12/2017 |