Provider Demographics
NPI:1619260130
Name:MARK HEYLIGERS DC PLLC
Entity Type:Organization
Organization Name:MARK HEYLIGERS DC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:HEYLIGERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:212-534-1500
Mailing Address - Street 1:127 E 107TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-3939
Mailing Address - Country:US
Mailing Address - Phone:212-534-1500
Mailing Address - Fax:212-860-8538
Practice Address - Street 1:127 E 107TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-3939
Practice Address - Country:US
Practice Address - Phone:212-534-1500
Practice Address - Fax:212-860-8538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX002510-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty