Provider Demographics
NPI:1609017110
Name:DOLPHIN CHIROPRACTIC CARE
Entity Type:Organization
Organization Name:DOLPHIN CHIROPRACTIC CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:WHITNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:516-208-8187
Mailing Address - Street 1:279 SUNRISE HWY
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4925
Mailing Address - Country:US
Mailing Address - Phone:516-594-1900
Mailing Address - Fax:516-594-1973
Practice Address - Street 1:279 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4925
Practice Address - Country:US
Practice Address - Phone:516-594-1900
Practice Address - Fax:516-594-1973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008858174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX6A231Medicare PIN
NYU70283Medicare UPIN