Provider Demographics
NPI:1053686584
Name:J. C. CHIROPRACTIC SERVICES P.C.
Entity Type:Organization
Organization Name:J. C. CHIROPRACTIC SERVICES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:VITO
Authorized Official - Last Name:CRESCIONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:516-388-1973
Mailing Address - Street 1:55 POST AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-4361
Mailing Address - Country:US
Mailing Address - Phone:516-338-1973
Mailing Address - Fax:516-338-1971
Practice Address - Street 1:55 POST AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-4361
Practice Address - Country:US
Practice Address - Phone:516-338-1973
Practice Address - Fax:516-338-1971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-16
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty