Provider Demographics
NPI:1457457525
Name:MODERN CHIROPRACTIC CARE, P.C.
Entity Type:Organization
Organization Name:MODERN CHIROPRACTIC CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-287-4200
Mailing Address - Street 1:421 OCEAN PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-5118
Mailing Address - Country:US
Mailing Address - Phone:718-287-4200
Mailing Address - Fax:718-287-4225
Practice Address - Street 1:421 OCEAN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-5118
Practice Address - Country:US
Practice Address - Phone:718-287-4200
Practice Address - Fax:718-287-4225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010648111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEP371Medicare ID - Type Unspecified