Provider Demographics
NPI:1629190590
Name:BERNHARD SENGSTOCK, DC, PC
Entity Type:Organization
Organization Name:BERNHARD SENGSTOCK, DC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNHARD
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SENGSTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:631-277-6767
Mailing Address - Street 1:152 ISLIP AVE
Mailing Address - Street 2:SUITE 23
Mailing Address - City:ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11751-3225
Mailing Address - Country:US
Mailing Address - Phone:631-277-6767
Mailing Address - Fax:631-277-4311
Practice Address - Street 1:152 ISLIP AVE
Practice Address - Street 2:SUITE 23
Practice Address - City:ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11751-3225
Practice Address - Country:US
Practice Address - Phone:631-277-6767
Practice Address - Fax:631-277-4311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007893111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU64473Medicare UPIN
NYX83911Medicare ID - Type Unspecified