Provider Demographics
NPI:1083030837
Name:HW CHIROPRACTIC PC
Entity Type:Organization
Organization Name:HW CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HYUNIK
Authorized Official - Middle Name:
Authorized Official - Last Name:HWANGBO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-939-5690
Mailing Address - Street 1:15015 41ST AVE STE 3C
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4929
Mailing Address - Country:US
Mailing Address - Phone:718-939-5690
Mailing Address - Fax:718-321-8524
Practice Address - Street 1:15015 41ST AVE STE 3C
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4929
Practice Address - Country:US
Practice Address - Phone:718-939-5690
Practice Address - Fax:718-321-8524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001699111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1568616845OtherNPI