Provider Demographics
NPI:1629388749
Name:PEET FAMILY CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:PEET FAMILY CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PEET
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:845-566-1313
Mailing Address - Street 1:2 SPRING SQUARE BUSINESS PARK
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-2567
Mailing Address - Country:US
Mailing Address - Phone:845-566-1313
Mailing Address - Fax:845-566-1379
Practice Address - Street 1:2 SPRING SQUARE BUSINESS PARK
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-2567
Practice Address - Country:US
Practice Address - Phone:845-566-1313
Practice Address - Fax:845-566-1379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-08
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004107-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX22191Medicare PIN