Provider Demographics
NPI:1689018855
Name:VELIKY CHIROPRACTIC GROUP
Entity Type:Organization
Organization Name:VELIKY CHIROPRACTIC GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:VELIKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:212-355-3377
Mailing Address - Street 1:11 E 47TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-1919
Mailing Address - Country:US
Mailing Address - Phone:212-355-3377
Mailing Address - Fax:
Practice Address - Street 1:11 E 47TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-1919
Practice Address - Country:US
Practice Address - Phone:212-355-3377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX-011735-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty