Provider Demographics
NPI:1619550548
Name:CITY INTEGRATIVE CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:CITY INTEGRATIVE CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:MALIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUDHRAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-563-4603
Mailing Address - Street 1:12 E 44TH ST FL 5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-3624
Mailing Address - Country:US
Mailing Address - Phone:646-256-9513
Mailing Address - Fax:
Practice Address - Street 1:12 E 44TH ST FL 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-3624
Practice Address - Country:US
Practice Address - Phone:646-256-9513
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty