Provider Demographics
NPI:1598837205
Name:SIRLIN, ANDREW L (DC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:L
Last Name:SIRLIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 OLD COUNTRY ROAD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803
Mailing Address - Country:US
Mailing Address - Phone:514-933-1034
Mailing Address - Fax:516-931-1084
Practice Address - Street 1:744 OLD COUNTRY ROAD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803
Practice Address - Country:US
Practice Address - Phone:514-933-1034
Practice Address - Fax:516-931-1084
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX044927111N00000X
NYX4492-7111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
10361OtherACCESS
320251OtherCIGNA
35914OtherVYTRA
X55571OtherBCBS
879965OtherAETNA
P767254OtherOXFORD
788849OtherMAIL HANDLERS
C044927OtherWIC
N28162OtherPHS NON PAR
2450OtherVYTRA MEDICARE
125202OtherACN
5897983OtherGHI
T52807Medicare UPIN
C044927OtherWIC