Provider Demographics
NPI:1053517334
Name:VINCIGUERRA FAMILY CHIROPRACTIC INC
Entity type:Organization
Organization Name:VINCIGUERRA FAMILY CHIROPRACTIC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PORRINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-475-3200
Mailing Address - Street 1:2500 GRUBB RD STE 132
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4711
Mailing Address - Country:US
Mailing Address - Phone:302-475-3200
Mailing Address - Fax:302-475-2516
Practice Address - Street 1:2500 GRUBB RD STE 132
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4711
Practice Address - Country:US
Practice Address - Phone:302-475-3200
Practice Address - Fax:302-475-2516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-280111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE250782634Medicaid