Provider Demographics
NPI:1043571680
Name:DR. ALLEN S. ROTHMAN CHIROPRACTOR, PC
Entity Type:Organization
Organization Name:DR. ALLEN S. ROTHMAN CHIROPRACTOR, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROTHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-331-5980
Mailing Address - Street 1:8738 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-5402
Mailing Address - Country:US
Mailing Address - Phone:718-331-5980
Mailing Address - Fax:718-331-5971
Practice Address - Street 1:8738 25TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-5402
Practice Address - Country:US
Practice Address - Phone:718-331-5980
Practice Address - Fax:718-331-5971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-30
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005986-1111N00000X
NJ38MC00614800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty