Provider Demographics
NPI:1073853644
Name:ENERGIZE CHIROPRACTIC P.C.
Entity Type:Organization
Organization Name:ENERGIZE CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:GRILLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:347-499-2100
Mailing Address - Street 1:10 VAN SICKLEN ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-2739
Mailing Address - Country:US
Mailing Address - Phone:347-499-2100
Mailing Address - Fax:347-214-7458
Practice Address - Street 1:10 VAN SICKLEN ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-2739
Practice Address - Country:US
Practice Address - Phone:347-499-2100
Practice Address - Fax:347-214-7458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-19
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008136-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty