Provider Demographics
NPI:1790352110
Name:HALFMOON CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:HALFMOON CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NABILAH
Authorized Official - Middle Name:JAHAN
Authorized Official - Last Name:KABIR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:518-248-0405
Mailing Address - Street 1:12 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:HALFMOON
Mailing Address - State:NY
Mailing Address - Zip Code:12065-8645
Mailing Address - Country:US
Mailing Address - Phone:518-383-3800
Mailing Address - Fax:518-734-0120
Practice Address - Street 1:12 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:HALFMOON
Practice Address - State:NY
Practice Address - Zip Code:12065-8645
Practice Address - Country:US
Practice Address - Phone:518-383-3800
Practice Address - Fax:518-734-0120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty