Provider Demographics
NPI:1487826004
Name:DIASPO CHIROPRACTIC & PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:DIASPO CHIROPRACTIC & PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENZWEIG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-894-2323
Mailing Address - Street 1:20817 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11428-1546
Mailing Address - Country:US
Mailing Address - Phone:718-465-4500
Mailing Address - Fax:718-479-6754
Practice Address - Street 1:20817 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11428-1546
Practice Address - Country:US
Practice Address - Phone:718-465-4500
Practice Address - Fax:718-479-6754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty