Provider Demographics
NPI:1346584265
Name:SPINEALIGN CORP.
Entity Type:Organization
Organization Name:SPINEALIGN CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:917-263-0969
Mailing Address - Street 1:1173A 2ND AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8277
Mailing Address - Country:US
Mailing Address - Phone:917-263-0969
Mailing Address - Fax:
Practice Address - Street 1:817 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7601
Practice Address - Country:US
Practice Address - Phone:917-263-0969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPINEALIGN CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty