DR. STEPHEN JAMES PETRUCCELLI (NPI# 1710045208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710045208 |
| Entity Type | Individual |
| Full Name | DR. STEPHEN JAMES PETRUCCELLI |
| Credential | D.C. |
| Practice Address |
39 Division Street Sag Harbor NY 11963 |
| Mailing Address |
Po Box 2902 Sag Harbor NY 11963-0401 |
| Practice Telephone | 6317258209 |
| Practice Fax Number | 6319191592 |
| Mailing Telephone | 6317258209 |
| Mailing Fax Number | 6317258209 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2011-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111NS0005X |
Chiropractor Specialization: Sports Physician |
X010203 | NY | Chiropractic Providers |
| Street Address |
39 DIVISION STREET |
| City | SAG HARBOR |
| State | NY |
| Zip Code | 11963 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013549807 | Twentyseveneastphysiotherapy PC | Physical Therapist | 34 Bay Street, Suite 206, Sag Harbor, NY 11963 | 2020-02-10 |
| 1407351646 | Sagaponack Medical PC | Clinic/Center | 3350 Noyack Rd, Sag Harbor, NY 11963 | 2018-03-29 |
| 1821331604 | Diana Immenhausen | Family Medicine | 3330 Noyac Road Burkeshire Court, Bldg A, Sag Harbor, NY 11963 | 2013-03-31 |
| 1386849651 | Kimberlee A Sherman | Registered Nurse | 1155 Bridghampton Turnpike, Bridgehampton, NY 11963 | 2007-06-18 |
| 1720280316 | Glenn Neal Goodman | Chiropractor | 3334 Noyac Road, Sag Harbor, NY 11963 | 2007-06-05 |
| 1811198203 | Jaime Lynn Kosinski | Speech-Language Pathologist | 22 Oak Drive, North Haven, Sag Harbor, NY 11963 | 2007-05-31 |
| 1942425798 | Victoria L Sharp | Internal Medicine | 11 Ninevah Pl, Sag Harbor, NY 11963 | 2007-04-16 |
| 1356462618 | Tod Reed Granger | Dentist | 3330 Noyac Road, Bldg B, Sag Harbor, NY 11963 | 2007-04-03 |
| 1841325628 | Suzanne Jayne Kirby | Chiropractor | 3334 Noyac Rd, Sag Harbor, NY 11963 | 2007-02-22 |
| 1427194745 | Sag Harbor Ufsd | Local Education Agency (LEA) | 200 Jermain Avenue, Sag Harbor, NY 11963 | 2007-01-30 |
| Find all providers in zip 11963 | ||||
| Taxonomy Code | 111NS0005X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Sports Physician |
| A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities. |
| Notes: Source: American Chiropractic Board of Sports Physicians, 2009 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215280276 | East End Sports Chiropractic, PC | Chiropractor | 39 Division St, Ground Flr, 2nd Offc From Rear, Sag Harbor, NY 11963-3156 | 2012-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043859150 | Brian Lotempio | Chiropractor | 435 5th Ave Fl 4, New York, NY 10016-2208 | 2020-01-06 |
| 1912462714 | Binghamton Chiropractic Pllc | Chiropractor | 95 Court St Ste G1, Binghamton, NY 13901-3312 | 2019-02-05 |
| 1912415845 | Tjb Chiropractic Pllc | Chiropractor | 10 Hanover Square, New York, NY 10005 | 2018-01-12 |
| 1093249799 | Natural Approach Chiropractic, PC | Chiropractor | 13618 39th Ave Ste 706, Flushing, NY 11354-5583 | 2017-04-19 |
| 1356688691 | Dr. Michael Fernandez Chiropractic, P.C. | Chiropractor | 2543 Route 44 55, Gardiner, NY 12525-5214 | 2013-01-07 |
| 1407105554 | Leigh Damkohler, Dc, PC | Chiropractor | 8 Bacon Pl, Yonkers, NY 10710-1204 | 2012-09-05 |
| 1477859775 | Brad Lacroix | Chiropractor | 287 Fall St, Seneca Falls, NY 13148-1516 | 2011-02-03 |
| 1376849604 | Robert James Bencivenga | Chiropractor | 27 Cedar Swamp Rd, Glen Cove, NY 11542-3728 | 2011-02-03 |
| 1952568792 | Mark A Capodanno | Chiropractor | 6 Wainer Ct, Centerport, NY 11721-1523 | 2008-05-20 |
| 1720275654 | Daniel C Minocchi | Chiropractor | 4545 Transit Rd Ste 640, Williamsville, NY 14221-6012 | 2007-09-25 |
| Find all providers with the same taxonomy | ||||
| City | SAG HARBOR |
| Zip Code | 11963 |
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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.