Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | X012284 | NY |
NPI | 1003156530 |
---|---|
Provider Name | Matthew B. Millanti |
First Address | East Amherst, NY 14051-1495 |
Second Address | East Amherst, NY 14051-1495 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2013 |
Last Update Date | 20/02/2013 |