Provider Demographics
NPI:1497973259
Name:STEVEN G. GEANOPULOS DC PC
Entity Type:Organization
Organization Name:STEVEN G. GEANOPULOS DC PC
Other - Org Name:FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:GEANOPULOS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:212-928-3300
Mailing Address - Street 1:812 W 181ST ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-4543
Mailing Address - Country:US
Mailing Address - Phone:212-928-3300
Mailing Address - Fax:212-740-2005
Practice Address - Street 1:812 W 181ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-4543
Practice Address - Country:US
Practice Address - Phone:212-928-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008387111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5805344OtherGHI
NYA2316262OtherAETNA/US HEALTHCARE
NYX2A301OtherBLUECROSS/BLUESHIELD
NYC08387-5OtherNY WORKERS COMPENSATION
NYC08387-5OtherNY WORKERS COMPENSATION
NYSGOX88521Medicare PIN