Provider Demographics
NPI:1942338579
Name:CHIROPRACTIC ASSOCIATES OF RICHMOND HILL PC
Entity Type:Organization
Organization Name:CHIROPRACTIC ASSOCIATES OF RICHMOND HILL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NISSENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-441-9390
Mailing Address - Street 1:105-09 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2014
Mailing Address - Country:US
Mailing Address - Phone:718-441-9390
Mailing Address - Fax:718-441-1061
Practice Address - Street 1:105-09 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-2014
Practice Address - Country:US
Practice Address - Phone:718-441-9390
Practice Address - Fax:718-441-1061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX2059111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY97039Medicare ID - Type Unspecified