Provider Demographics
NPI:1598838559
Name:R INTER CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:R INTER CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RENATO
Authorized Official - Middle Name:PIETRO
Authorized Official - Last Name:BATTISTI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-244-1644
Mailing Address - Street 1:6 MARLBORO RD
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590
Mailing Address - Country:US
Mailing Address - Phone:516-841-5732
Mailing Address - Fax:516-414-4260
Practice Address - Street 1:230 59 ROCKAWAY BLVD
Practice Address - Street 2:STE 225
Practice Address - City:JAMACIA
Practice Address - State:NY
Practice Address - Zip Code:11431
Practice Address - Country:US
Practice Address - Phone:718-244-1644
Practice Address - Fax:718-244-1622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0098211111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY09821Medicaid
NY09821Medicaid
U83988Medicare UPIN