Provider Demographics
NPI:1508036914
Name:MANHATTAN ADVANCED CHIROPRACTIC SERVICES, PC
Entity Type:Organization
Organization Name:MANHATTAN ADVANCED CHIROPRACTIC SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:C.
Authorized Official - Middle Name:EDMUND
Authorized Official - Last Name:SHOCKEY
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:212-227-3350
Mailing Address - Street 1:PO BOX 4434
Mailing Address - Street 2:GRAND CENTRAL STATION
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10693-4434
Mailing Address - Country:US
Mailing Address - Phone:212-227-3350
Mailing Address - Fax:212-227-3379
Practice Address - Street 1:160 BROADWAY
Practice Address - Street 2:6TH FLOOR EAST BUILDING
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4201
Practice Address - Country:US
Practice Address - Phone:212-227-3350
Practice Address - Fax:212-227-3379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011246-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty