Provider Demographics
NPI:1164727491
Name:NASSAU CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:NASSAU CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CHAMBERLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:516-314-3924
Mailing Address - Street 1:1 RAISIG AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-3217
Mailing Address - Country:US
Mailing Address - Phone:516-887-8808
Mailing Address - Fax:516-887-8809
Practice Address - Street 1:1 RAISIG AVE
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-3217
Practice Address - Country:US
Practice Address - Phone:516-887-8808
Practice Address - Fax:516-887-8809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007733111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty