Faillace, Eugene Russell

Faillace, Eugene Russell is an sole proprietor health care provider with primary practice located at 3075 Veterans Memorial Hwy Ste 101 , Ronkonkoma NY 11779-7600. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Faillace, Eugene Russell can be contacted via phone (631) 708-5573.

Contact Information

Primary practice address
3075 Veterans Memorial Hwy Ste 101 Ronkonkoma NY 11779-7600
Phone: (631) 708-5573
Fax: (631) 619-6543
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X X007958 New York

Profile Details

NPI number 1164488896
LBN Legal business name Faillace, Eugene Russell
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 21st, 2006
Last updated Dec 10th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164488896 NPPES
New York Other X007958 NYS LICENSE

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