Provider Demographics
NPI:1922376862
Name:GLEN HEAD CHIROPRACTIC & PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:GLEN HEAD CHIROPRACTIC & PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:516-759-2032
Mailing Address - Street 1:189 FOREST AVE STE A
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2068
Mailing Address - Country:US
Mailing Address - Phone:516-759-2032
Mailing Address - Fax:516-759-2117
Practice Address - Street 1:189 FOREST AVE STE A
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2068
Practice Address - Country:US
Practice Address - Phone:516-759-2032
Practice Address - Fax:516-759-2117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-07
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1053481168OtherNPI
NY320634OtherAETNA
NYP4467448OtherOXFORD
NY1629152921Other1199 UNION
NY2416954OtherGHI
NY2839005OtherUNITED HEALTH CARE
NY320634OtherMPN
NYQ290L1OtherEMPIRE BLUE CROSS BLUE SHIELD
NY0492010OtherCIGNA / ORTHONET
NY535524OtherUNITEDHEATLH CARE
NY1629152921OtherNPI
NY320634OtherTHE EMPIRE PLAN
NY4964083OtherCIGNA
NY1002695OtherEMPIRE BLUE CROSS BLUE SHIELD
NY1002695OtherAMERICAN SPECIALTY HEATLH NETWORKS
NYP4449350OtherOXFORD
NY1053481168Other1199 UNION
NY1629152921OtherNPI
NY320634OtherMPN