Provider Demographics
NPI:1124563192
Name:CHIROPRACTIC WELLNES OF FIDI NYC, PC
Entity Type:Organization
Organization Name:CHIROPRACTIC WELLNES OF FIDI NYC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAIT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:212-964-6000
Mailing Address - Street 1:64 FULTON ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-1854
Mailing Address - Country:US
Mailing Address - Phone:212-964-6000
Mailing Address - Fax:212-566-7433
Practice Address - Street 1:64 FULTON ST
Practice Address - Street 2:SUITE 303
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-1854
Practice Address - Country:US
Practice Address - Phone:212-964-6000
Practice Address - Fax:212-566-7433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-30
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006013111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty