Provider Demographics
NPI:1629348602
Name:DANIEL LEE WHITE,CHIROPRACTOR, PC
Entity Type:Organization
Organization Name:DANIEL LEE WHITE,CHIROPRACTOR, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:212-877-5726
Mailing Address - Street 1:590 W END AVE
Mailing Address - Street 2:APT 2B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1722
Mailing Address - Country:US
Mailing Address - Phone:212-877-5726
Mailing Address - Fax:646-304-6804
Practice Address - Street 1:590 W END AVE
Practice Address - Street 2:APT 2B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1722
Practice Address - Country:US
Practice Address - Phone:212-877-5726
Practice Address - Fax:646-304-6804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0005021-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty