Provider Demographics
NPI:1518174481
Name:GINZBURG, ASYA (DC)
Entity Type:Individual
Prefix:DR
First Name:ASYA
Middle Name:
Last Name:GINZBURG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 NEWFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-2908
Mailing Address - Country:US
Mailing Address - Phone:203-588-0122
Mailing Address - Fax:
Practice Address - Street 1:927 HOPE ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06907-2202
Practice Address - Country:US
Practice Address - Phone:203-323-2111
Practice Address - Fax:203-323-5040
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001020111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor