Provider Demographics
NPI:1699217026
Name:DRRLHARDY
Entity Type:Organization
Organization Name:DRRLHARDY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSHAUN
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:914-879-4572
Mailing Address - Street 1:15200 LEICESTERSHIRE ST UNIT 234
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-5924
Mailing Address - Country:US
Mailing Address - Phone:914-879-4572
Mailing Address - Fax:
Practice Address - Street 1:15200 LEICESTERSHIRE ST UNIT 234
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-5924
Practice Address - Country:US
Practice Address - Phone:914-879-4572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-16
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty