Provider Demographics
NPI:1225627029
Name:SYLVAN CHIROPRACTIC MASSAGE, PC
Entity Type:Organization
Organization Name:SYLVAN CHIROPRACTIC MASSAGE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MINSOK
Authorized Official - Middle Name:
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-767-7958
Mailing Address - Street 1:460 SYLVAN AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2923
Mailing Address - Country:US
Mailing Address - Phone:201-408-4754
Mailing Address - Fax:
Practice Address - Street 1:460 SYLVAN AVE STE 205
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-2923
Practice Address - Country:US
Practice Address - Phone:201-408-4754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty