Provider Demographics
NPI:1336330042
Name:AMBOY CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:AMBOY CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:BOVE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-948-9598
Mailing Address - Street 1:7378 AMBOY RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10307-1420
Mailing Address - Country:US
Mailing Address - Phone:718-948-9598
Mailing Address - Fax:718-605-2992
Practice Address - Street 1:7378 AMBOY RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10307-1420
Practice Address - Country:US
Practice Address - Phone:718-948-9598
Practice Address - Fax:718-605-2992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty