Provider Demographics
NPI:1639468309
Name:CORTLANDT CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:CORTLANDT CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:MANISHA
Authorized Official - Middle Name:B
Authorized Official - Last Name:PATEL-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:914-788-8793
Mailing Address - Street 1:220 TATE AVE
Mailing Address - Street 2:3
Mailing Address - City:BUCHANAN
Mailing Address - State:NY
Mailing Address - Zip Code:10511-1118
Mailing Address - Country:US
Mailing Address - Phone:914-788-8793
Mailing Address - Fax:877-453-2486
Practice Address - Street 1:220 TATE AVE
Practice Address - Street 2:3
Practice Address - City:BUCHANAN
Practice Address - State:NY
Practice Address - Zip Code:10511-1118
Practice Address - Country:US
Practice Address - Phone:914-788-8793
Practice Address - Fax:877-453-2486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty