Provider Demographics
NPI:1235405051
Name:S.P.E. CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:S.P.E. CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SWEET
Authorized Official - Middle Name:PRECIOUS
Authorized Official - Last Name:EHIGIEGBA
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:646-229-2290
Mailing Address - Street 1:2180 HUGHES AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-1664
Mailing Address - Country:US
Mailing Address - Phone:646-229-2290
Mailing Address - Fax:
Practice Address - Street 1:14040 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-3220
Practice Address - Country:US
Practice Address - Phone:718-480-6794
Practice Address - Fax:718-480-6985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011734111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty