Provider Demographics
NPI:1871681932
Name:KIBEL, CAROLYN BETH (DC)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:BETH
Last Name:KIBEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:573 WOODBURY RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1010
Mailing Address - Country:US
Mailing Address - Phone:516-681-4567
Mailing Address - Fax:516-938-5001
Practice Address - Street 1:573 WOODBURY RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1010
Practice Address - Country:US
Practice Address - Phone:516-681-4567
Practice Address - Fax:516-938-5001
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX002658-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor