Provider Demographics
NPI:1023192945
Name:ASHBURN FAMILY CHIROPRACTIC PC
Entity Type:Organization
Organization Name:ASHBURN FAMILY CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:N
Authorized Official - Last Name:ASHBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-896-1200
Mailing Address - Street 1:209 OLD ROUTE 9
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-2472
Mailing Address - Country:US
Mailing Address - Phone:845-896-1200
Mailing Address - Fax:845-896-3501
Practice Address - Street 1:209 OLD ROUTE 9
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-2472
Practice Address - Country:US
Practice Address - Phone:845-896-1200
Practice Address - Fax:845-896-3501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8664111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX3A951Medicare ID - Type Unspecified