Provider Demographics
NPI:1114111994
Name:PRIMARY ZONE CHIROPRACTIC. PC
Entity Type:Organization
Organization Name:PRIMARY ZONE CHIROPRACTIC. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANG
Authorized Official - Middle Name:W
Authorized Official - Last Name:WOO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-424-1454
Mailing Address - Street 1:8908 ROOSEVELT AVE
Mailing Address - Street 2:2ND FL.
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-7857
Mailing Address - Country:US
Mailing Address - Phone:718-424-1454
Mailing Address - Fax:718-424-1412
Practice Address - Street 1:8908 ROOSEVELT AVE
Practice Address - Street 2:2ND FL.
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7857
Practice Address - Country:US
Practice Address - Phone:718-424-1454
Practice Address - Fax:718-424-1412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010435111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty