Provider Demographics
NPI:1891797411
Name:GORELIK, MICHAEL (DC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:GORELIK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2533 BATCHELDER ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-1420
Mailing Address - Country:US
Mailing Address - Phone:718-376-2010
Mailing Address - Fax:718-375-9655
Practice Address - Street 1:444 AVENUE X
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-6053
Practice Address - Country:US
Practice Address - Phone:718-376-2010
Practice Address - Fax:718-375-9655
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010033111N00000X
NJMC005753111N00000X
FLCH8904111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02290040Medicaid
NY02290040Medicaid
NYU84254Medicare UPIN