Provider Demographics
NPI:1821362062
Name:THODEN, PIERRE HINRICH (DC)
Entity Type:Individual
Prefix:DR
First Name:PIERRE
Middle Name:HINRICH
Last Name:THODEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:PIERRE
Other - Middle Name:HINRICH
Other - Last Name:THODEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:333 MEACHAM AVE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-3219
Mailing Address - Country:US
Mailing Address - Phone:516-358-0902
Mailing Address - Fax:516-328-6322
Practice Address - Street 1:333 MEACHAM AVE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-3219
Practice Address - Country:US
Practice Address - Phone:516-358-0902
Practice Address - Fax:516-328-6322
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005015111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner