Provider Demographics
NPI:1831286103
Name:REMY, MICHAEL C (DC,DABCO,CCSP)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:C
Last Name:REMY
Suffix:
Gender:M
Credentials:DC,DABCO,CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 903
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD LANDING
Mailing Address - State:NY
Mailing Address - Zip Code:11547-0903
Mailing Address - Country:US
Mailing Address - Phone:516-676-2040
Mailing Address - Fax:516-676-0566
Practice Address - Street 1:121 KISSAM LANE
Practice Address - Street 2:
Practice Address - City:GLENWOOD LANDING
Practice Address - State:NY
Practice Address - Zip Code:11547-0903
Practice Address - Country:US
Practice Address - Phone:516-676-2040
Practice Address - Fax:516-676-0566
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006098-1111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU18088Medicare UPIN
NYX37161Medicare ID - Type Unspecified