Provider Demographics
NPI:1033550116
Name:ESTHER JIMENEZ DC, P.C.
Entity Type:Organization
Organization Name:ESTHER JIMENEZ DC, P.C.
Other - Org Name:LIFESPA CHIROPRACTIC AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:516-868-8100
Mailing Address - Street 1:180 N LONG BEACH RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4409
Mailing Address - Country:US
Mailing Address - Phone:516-868-8100
Mailing Address - Fax:516-623-5941
Practice Address - Street 1:180 N LONG BEACH RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4409
Practice Address - Country:US
Practice Address - Phone:516-868-8100
Practice Address - Fax:516-623-5941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008840302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization