Provider Demographics
NPI:1053443754
Name:ELMSFORD CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:ELMSFORD CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:AXELROD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:914-345-6700
Mailing Address - Street 1:64 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523-3505
Mailing Address - Country:US
Mailing Address - Phone:914-345-6700
Mailing Address - Fax:914-345-6025
Practice Address - Street 1:64 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-3505
Practice Address - Country:US
Practice Address - Phone:914-345-6700
Practice Address - Fax:914-345-6025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWYPVX1Medicare PIN