Provider Demographics
NPI:1477722130
Name:ROCKY POINT CHIROPRACTIC PC
Entity Type:Organization
Organization Name:ROCKY POINT CHIROPRACTIC PC
Other - Org Name:ROCKY POINT PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALEXA
Authorized Official - Middle Name:
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-821-2112
Mailing Address - Street 1:532 ROUTE 25A
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11778-8759
Mailing Address - Country:US
Mailing Address - Phone:631-821-2112
Mailing Address - Fax:631-821-5929
Practice Address - Street 1:532 ROUTE 25A
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778-8759
Practice Address - Country:US
Practice Address - Phone:631-821-2112
Practice Address - Fax:631-821-5929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04310005Medicaid
NY04287638Medicaid
NYQ62651OtherMEDICARE PIN