Dr. Ricky Sam Cavallaro, DC
Chiropractor in Syracuse, NY. Individual provider (NPI-1).
NPI number1295809671
StatusActive
Last updated in NPPESMay 23, 2011
Details
- NPI
- 1295809671
- Entity type
- Individual (NPI-1)
- Name
- Dr. Ricky Sam Cavallaro
- Credential
- DC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Nov 20, 2006
- Last updated
- May 23, 2011
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CHIROPRACTIC
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | x006530 | NY | Yes |
Practice location
100 Osceola PlSyracuse, NY 13209-1229
Phone 315-487-5200 · Fax 315-487-1110
Mailing address
100 Osceola PlSyracuse, NY 13209-9500
Phone 315-487-5200
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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