Provider Demographics
NPI:1316571573
Name:RIVERHEAD CHIROPRACTIC AND PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:RIVERHEAD CHIROPRACTIC AND PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI-ANNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:ALBANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-996-0337
Mailing Address - Street 1:1081 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-2019
Mailing Address - Country:US
Mailing Address - Phone:516-520-5026
Mailing Address - Fax:
Practice Address - Street 1:1081 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-2019
Practice Address - Country:US
Practice Address - Phone:516-520-5026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty