Provider Demographics
NPI:1437484433
Name:DR. WALTER ALEXOVITZ D.C.P.C.
Entity Type:Organization
Organization Name:DR. WALTER ALEXOVITZ D.C.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXOVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:631-281-7810
Mailing Address - Street 1:1273 WILLIAM FLOYD PKWY
Mailing Address - Street 2:
Mailing Address - City:SHIRLEY
Mailing Address - State:NY
Mailing Address - Zip Code:11967-1810
Mailing Address - Country:US
Mailing Address - Phone:631-281-7810
Mailing Address - Fax:631-281-7883
Practice Address - Street 1:1273 WILLIAM FLOYD PKWY
Practice Address - Street 2:
Practice Address - City:SHIRLEY
Practice Address - State:NY
Practice Address - Zip Code:11967-1810
Practice Address - Country:US
Practice Address - Phone:631-281-7810
Practice Address - Fax:631-281-7883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-08
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006743111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX51811Medicare UPIN