Provider Demographics
NPI:1558636456
Name:ATLAS CHIROPRACTIC REHABILITATION PC
Entity Type:Organization
Organization Name:ATLAS CHIROPRACTIC REHABILITATION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DC
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:JON
Authorized Official - Last Name:KRITZBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-763-1300
Mailing Address - Street 1:225 MERRICK RD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-1430
Mailing Address - Country:US
Mailing Address - Phone:516-763-1300
Mailing Address - Fax:516-763-1313
Practice Address - Street 1:225 MERRICK RD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-1430
Practice Address - Country:US
Practice Address - Phone:516-763-1300
Practice Address - Fax:516-763-1313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-12
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011877111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty