Provider Demographics
NPI:1831304518
Name:UNIVERSITY PLACE CHIROPRACTIC, P,C
Entity Type:Organization
Organization Name:UNIVERSITY PLACE CHIROPRACTIC, P,C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARCHER
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:IRBY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:212-995-1717
Mailing Address - Street 1:99 UNIVERSITY PL
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4528
Mailing Address - Country:US
Mailing Address - Phone:212-995-1727
Mailing Address - Fax:212-979-0021
Practice Address - Street 1:99 UNIVERSITY PL
Practice Address - Street 2:6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4528
Practice Address - Country:US
Practice Address - Phone:212-995-1727
Practice Address - Fax:212-979-0021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009515111N00000X
NYX010162111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========Other1199
NY=========OtherAETNA
NY=========OtherOXFORD
NY=========OtherBCBS
NY=========OtherUHC
NYXHW931Medicare ID - Type Unspecified