AXIS INTEGRATIVE MEDICAL, PC (NPI# 1235574963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235574963 |
| Entity Type | Organization |
| Organization Name | AXIS INTEGRATIVE MEDICAL, PC |
| Practice Address |
879 Commerce St Thornwood NY 10594-1415 |
| Practice Telephone | 9147479200 |
| Practice Fax Number | 9147474406 |
| Mailing Telephone | 9147479200 |
| Mailing Fax Number | 9147474406 |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2013-05-08 |
| Authorized Official Name | DR. WILDER RUCKER (OWNER) |
| Authorized Official Telephone | 9147479200 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204C00000X | Neuromusculoskeletal Medicine, Sports Medicine | 264414 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
879 COMMERCE ST |
| City | THORNWOOD |
| State | NY |
| Zip Code | 10594-1415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861576613 | Tina Sacchetti | Chiropractor | 879 Commerce St, Thornwood, NY 10594-1415 | 2006-10-25 |
| 1891141750 | Rye Brook Physical Medicine and Rehabilitation, P.C. | Physical Medicine & Rehabilitation | 879 Commerce St, Thornwood, NY 10594-1415 | 2016-05-10 |
| 1730457441 | Advanced Integrative Medical PC | Acupuncturist | 879 Commerce St, Thornwood, NY 10594-1415 | 2011-12-08 |
| 1073881355 | Nicole Desrochers | Specialist | 879 Commerce St, Thornwood, NY 10594-1415 | 2011-12-01 |
| 1679804967 | Sarah Amodei | Specialist | 879 Commerce St, Thornwood, NY 10594-1415 | 2010-01-26 |
| 1205084241 | Advanced Spinal Therapy and Chiropractic Care, Pllc | Chiropractor | 879 Commerce St, Thornwood, NY 10594-1415 | 2008-09-03 |
| 1992836621 | Stephen Rocco Giorgio | Chiropractor | 879 Commerce St, Thornwood, NY 10594-1415 | 2007-03-07 |
| 1659402337 | Chiropactic & Wellness Care, Pllc | Chiropractor | 879 Commerce St, Thornwood, NY 10594-1415 | 2007-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073083093 | Elizabeth Huffaker | Nurse Practitioner | 30 Highland Road, Thornwood, NY 10594 | 2018-12-03 |
| 1255823126 | Ellen Patricia Huvane | Occupational Therapist | 103 Byron Road, Thornwood, NY 10594 | 2018-06-05 |
| 1134660145 | Towfiq Majumder | Pharmacist | 35 Kensico Road, Thornwood, NY 10594 | 2017-03-10 |
| 1134594161 | Pleasantville Ambulance Corps, Inc | Ambulance | 30 Gramercy Place, Thornwood, NY 10594 | 2015-12-02 |
| 1942495957 | Johanna Helen Prescott | Licensed Practical Nurse | 76 Witter Drive, Thornwood, NY 10594 | 2007-09-12 |
| 1902028426 | Willie M Butler | Licensed Practical Nurse | 501 Swanson Drive, Thornwood, NY 10594 | 2007-05-03 |
| 1215001854 | Thomas Gabriel Newman Jr. | Internal Medicine | 196 Nannyhagen Rd, Thornwood, NY 10594 | 2006-11-17 |
| 1396814950 | James A Dicicco | Dentist | 677 Commerce Street, Thornwood, NY 10594 | 2006-11-07 |
| 1609959121 | Nancy R Beran | Internal Medicine | 645 Marble Ave, Thornwood, NY 10594 | 2006-10-21 |
| 1871691428 | Cvs Albany LLC | Pharmacy | 1024 Broadway Thornwood Cntr, Thornwood, NY 10594 | 2006-09-20 |
| Find all providers in zip 10594 | ||||
| Taxonomy Code | 204C00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neuromusculoskeletal Medicine, Sports Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003459975 | Zachary Bevilacqua | Neuromusculoskeletal Medicine, Sports Medicine | 123 Medallion Cir, Rochester, NY 14626-3242 | 2019-10-23 |
| 1518479898 | Dr. Salibs Medical Practice PC | Neuromusculoskeletal Medicine, Sports Medicine | 11622 Queens Blvd, Forest Hills, NY 11375-7055 | 2017-10-26 |
| 1316467988 | Ens Medical PC | Neuromusculoskeletal Medicine, Sports Medicine | 205 W 54th St Apt 11a, New York, NY 10019-5535 | 2017-06-23 |
| 1780812818 | Bernard Joseph Zumpano | Neuromusculoskeletal Medicine, Sports Medicine | 5683 Walker Rd, Utica, NY 13502-1249 | 2009-06-26 |
| 1134305311 | Randolph Rosarion | Neuromusculoskeletal Medicine, Sports Medicine | 12010 15th Ave, Rm. 6, College Point, NY 11356-1617 | 2008-01-17 |
| 1316158397 | Stephen Klein | Neuromusculoskeletal Medicine, Sports Medicine | 213-33 39th Ave., Suite 240, Bayside, NY 11361 | 2007-05-24 |
| 1881718617 | Lawrence J. Kagen | Neuromusculoskeletal Medicine, Sports Medicine | 3050 Fairfield Ave, Bronx, NY 10463-3314 | 2007-03-19 |
| 1477691061 | Paul Baxt | Neuromusculoskeletal Medicine, Sports Medicine | 140 Riverside Blvd, Ste 2602, New York, NY 10069-0601 | 2007-02-03 |
| 1972656452 | David M Dines | Neuromusculoskeletal Medicine, Sports Medicine | 935 Northern Blvd Ste 303, Great Neck, NY 11021-5309 | 2007-01-19 |
| 1447302211 | West End Medical PC | Neuromusculoskeletal Medicine, Sports Medicine | 11 W End Ave Ste 1, Brooklyn, NY 11235-4812 | 2007-01-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.