Provider Demographics
NPI:1609194679
Name:BABYLON CHIROPRACTIC OFFICE
Entity Type:Organization
Organization Name:BABYLON CHIROPRACTIC OFFICE
Other - Org Name:BABYLON CHIROPRACTIC OFFICE
Other - Org Type:Other Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:631-587-0872
Mailing Address - Street 1:799 DEER PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-3812
Mailing Address - Country:US
Mailing Address - Phone:631-587-0872
Mailing Address - Fax:631-587-0855
Practice Address - Street 1:799 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-3812
Practice Address - Country:US
Practice Address - Phone:631-587-0872
Practice Address - Fax:631-587-0855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-14
Last Update Date:2011-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0064460-1111N00000X
NYX006487-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty