Provider Demographics
NPI:1619027455
Name:PFEIFER, JOSEPH E (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:E
Last Name:PFEIFER
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 1:881 HAWKINS AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE GROVE
Mailing Address - State:NY
Mailing Address - Zip Code:11755-1601
Mailing Address - Country:US
Mailing Address - Phone:631-588-3388
Mailing Address - Fax:631-588-5968
Practice Address - Street 1:881 HAWKINS AVE
Practice Address - Street 2:
Practice Address - City:LAKE GROVE
Practice Address - State:NY
Practice Address - Zip Code:11755-1601
Practice Address - Country:US
Practice Address - Phone:631-588-3388
Practice Address - Fax:631-588-5968
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004179111NN0400X, 111NS0005X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111NN0400XChiropractic ProvidersChiropractorNeurology
Not Answered111NS0005XChiropractic ProvidersChiropractorSports Physician
Not Answered111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY26904OtherGHI
NY1025707OtherAETNA
NY125619OtherACN
NYC04179-0OtherWORKERS' COMP
NYSF00000371OtherSELECT PRO
NYX8851OtherBLUE CHOICE
NY1025707OtherAETNA
NYX8851OtherBLUE CHOICE