Provider Demographics
NPI:1073985669
Name:QUEENSBURY FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:QUEENSBURY FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:STEINBERG
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:518-798-1111
Mailing Address - Street 1:959 STATE ROUTE 9
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804
Mailing Address - Country:US
Mailing Address - Phone:518-798-1111
Mailing Address - Fax:518-792-3943
Practice Address - Street 1:959 STATE ROUTE 9
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804
Practice Address - Country:US
Practice Address - Phone:518-798-1111
Practice Address - Fax:518-792-3943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011317-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty