Provider Demographics
NPI:1962031310
Name:ATLANTIC HEALTHCARE ASSOCIATES
Entity Type:Organization
Organization Name:ATLANTIC HEALTHCARE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING AGENT
Authorized Official - Prefix:
Authorized Official - First Name:OKSANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MINAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-580-9191
Mailing Address - Street 1:PO BOX 32303
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21282-2303
Mailing Address - Country:US
Mailing Address - Phone:410-580-9191
Mailing Address - Fax:410-500-5211
Practice Address - Street 1:7034 LIBERTY RD
Practice Address - Street 2:
Practice Address - City:GWYNN OAK
Practice Address - State:MD
Practice Address - Zip Code:21207-5801
Practice Address - Country:US
Practice Address - Phone:410-580-9191
Practice Address - Fax:410-500-5211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty