Provider Demographics
NPI:1225061369
Name:SENGSTOCK, BERNHARD JOHN II (DC)
Entity Type:Individual
Prefix:DR
First Name:BERNHARD
Middle Name:JOHN
Last Name:SENGSTOCK
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 ISLIP AVE
Mailing Address - Street 2:SUITE 23
Mailing Address - City:ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11751-3225
Mailing Address - Country:US
Mailing Address - Phone:631-277-6767
Mailing Address - Fax:631-277-4311
Practice Address - Street 1:152 ISLIP AVE
Practice Address - Street 2:SUITE 23
Practice Address - City:ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11751-3225
Practice Address - Country:US
Practice Address - Phone:631-277-6767
Practice Address - Fax:631-277-4311
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007893111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX83911Medicare ID - Type Unspecified
NYU64473Medicare UPIN