Provider Demographics
NPI:1477279271
Name:MID HUDSON CHIROPRACTIC AND PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:MID HUDSON CHIROPRACTIC AND PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DARRIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KALOZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-418-0432
Mailing Address - Street 1:1354 MIDLAND AVE APT 2T
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-6806
Mailing Address - Country:US
Mailing Address - Phone:646-418-0432
Mailing Address - Fax:
Practice Address - Street 1:203 WICKHAM AVE STE 104
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-3852
Practice Address - Country:US
Practice Address - Phone:845-775-3625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty