Provider Demographics
NPI:1578695383
Name:HUML DC INTEGRATIVE HEALTHCARE PC
Entity Type:Organization
Organization Name:HUML DC INTEGRATIVE HEALTHCARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:HUML
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-748-6644
Mailing Address - Street 1:430 79TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3708
Mailing Address - Country:US
Mailing Address - Phone:718-748-6644
Mailing Address - Fax:718-748-6851
Practice Address - Street 1:430 79TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3708
Practice Address - Country:US
Practice Address - Phone:718-748-6644
Practice Address - Fax:718-748-6851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX2512111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100001170Medicare PIN