Provider Demographics
NPI:1740574078
Name:WESTCHESTER CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:WESTCHESTER CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDD
Authorized Official - Middle Name:P
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:914-961-7575
Mailing Address - Street 1:83 MONTGOMERY AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5104
Mailing Address - Country:US
Mailing Address - Phone:914-961-7575
Mailing Address - Fax:
Practice Address - Street 1:83 MONTGOMERY AVE
Practice Address - Street 2:SUITE A
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5104
Practice Address - Country:US
Practice Address - Phone:914-961-7575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX9805111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU89139Medicare UPIN