Provider Demographics
NPI:1811399231
Name:CHAD R. BRIGOCKAS
Entity Type:Organization
Organization Name:CHAD R. BRIGOCKAS
Other - Org Name:SOUTH SLOPE ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:R
Authorized Official - Last Name:BRIGOCKAS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:347-276-3373
Mailing Address - Street 1:342 20TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-6404
Mailing Address - Country:US
Mailing Address - Phone:347-276-3373
Mailing Address - Fax:
Practice Address - Street 1:342 20TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-6404
Practice Address - Country:US
Practice Address - Phone:347-276-3373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty