Provider Demographics
NPI:1447567177
Name:NEKTALOV FAMILY CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:NEKTALOV FAMILY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:NEKTALOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-554-8580
Mailing Address - Street 1:41-01 UTOPIA PKWY
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14751 CHARTER RD
Practice Address - Street 2:#23D
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-6365
Practice Address - Country:US
Practice Address - Phone:347-554-8580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty