Provider Demographics
NPI:1114227071
Name:SFS CONGERS INC
Entity Type:Organization
Organization Name:SFS CONGERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:RUSSO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:845-268-5122
Mailing Address - Street 1:285 N ROUTE 303
Mailing Address - Street 2:SUITE # 2
Mailing Address - City:CONGERS
Mailing Address - State:NY
Mailing Address - Zip Code:10920-1413
Mailing Address - Country:US
Mailing Address - Phone:845-268-5122
Mailing Address - Fax:
Practice Address - Street 1:285 N ROUTE 303
Practice Address - Street 2:SUITE # 2
Practice Address - City:CONGERS
Practice Address - State:NY
Practice Address - Zip Code:10920-1413
Practice Address - Country:US
Practice Address - Phone:845-268-5122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX002602-2111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty