Provider Demographics
NPI:1467772947
Name:OCEAN CHIROPRACTIC CARE, P.C
Entity Type:Organization
Organization Name:OCEAN CHIROPRACTIC CARE, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OLEG
Authorized Official - Middle Name:
Authorized Official - Last Name:BARSHAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-934-5395
Mailing Address - Street 1:2518 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3916
Mailing Address - Country:US
Mailing Address - Phone:718-934-5395
Mailing Address - Fax:718-616-0921
Practice Address - Street 1:2518 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3916
Practice Address - Country:US
Practice Address - Phone:718-934-5395
Practice Address - Fax:718-616-0921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007419-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX007419-1OtherLICENSE#
NY03055281Medicaid
NYX56341Medicare PIN
NYX007419-1OtherLICENSE#