Provider Demographics
NPI:1811031347
Name:TOLK, GEORGE ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ROBERT
Last Name:TOLK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 WEST END AVENUE
Mailing Address - Street 2:DOCTORS OFFICE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024
Mailing Address - Country:US
Mailing Address - Phone:212-496-0101
Mailing Address - Fax:212-496-0206
Practice Address - Street 1:495 WEST END AVENUE
Practice Address - Street 2:DOCTORS OFFICE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024
Practice Address - Country:US
Practice Address - Phone:212-496-0101
Practice Address - Fax:212-496-0206
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX003646111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYGTOX206710OtherATN
NYP3199268OtherOXF
NY133199268OtherUHC
NYGTOX206710OtherPFG
NY603827OtherACN
NY0043662OtherHF
NY133199268OtherHNE
NY133199268OtherGUARDIAN
NY0043662OtherGHI
NY133199268OtherCIGNA
NYGTOX206710OtherCOM
NYGTOX206710OtherPFG