Provider Demographics
NPI:1245566850
Name:TABICK SPECIFIC CHIROPRACTIC P.C.
Entity Type:Organization
Organization Name:TABICK SPECIFIC CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:TABICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:845-517-4955
Mailing Address - Street 1:71 ROUTE 59 STE G
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-3778
Mailing Address - Country:US
Mailing Address - Phone:845-517-4955
Mailing Address - Fax:845-517-4958
Practice Address - Street 1:71 ROUTE 59 STE G
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-3778
Practice Address - Country:US
Practice Address - Phone:845-517-4955
Practice Address - Fax:845-517-4958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009048111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty