Provider Demographics
NPI:1225106552
Name:EGLAUF, PATRICK J (DC)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:J
Last Name:EGLAUF
Suffix:
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 1:30 GREENRIDGE AVE SUITE 2K
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605
Mailing Address - Country:US
Mailing Address - Phone:914-761-1886
Mailing Address - Fax:914-949-8271
Practice Address - Street 1:30 GREENRIDGE AVE SUITE 2K
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605
Practice Address - Country:US
Practice Address - Phone:914-761-1886
Practice Address - Fax:914-949-8271
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007298-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY13-4145259OtherTAX ID
NYX61831Medicare PIN