Provider Demographics
NPI:1689654121
Name:TAYLOR, CLAUDIA JOAN (DC)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:JOAN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 S COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11719-9768
Mailing Address - Country:US
Mailing Address - Phone:631-286-5858
Mailing Address - Fax:631-286-5859
Practice Address - Street 1:366 S COUNTRY RD
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11719-9768
Practice Address - Country:US
Practice Address - Phone:631-286-5858
Practice Address - Fax:631-286-5859
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX003511-1111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
X21301Medicare ID - Type Unspecified