Provider Demographics
NPI:1013138155
Name:ZIA-SHAKERI CHIROPRACTIC CLINIC, PA
Entity Type:Organization
Organization Name:ZIA-SHAKERI CHIROPRACTIC CLINIC, PA
Other - Org Name:OCEAN CITY CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIASHAKERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-213-1233
Mailing Address - Street 1:12417 OCEAN GTWY STE 2A
Mailing Address - Street 2:
Mailing Address - City:OCEAN CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21842-9522
Mailing Address - Country:US
Mailing Address - Phone:410-213-1233
Mailing Address - Fax:410-213-1234
Practice Address - Street 1:12417 OCEAN GTWY STE 2A
Practice Address - Street 2:
Practice Address - City:OCEAN CITY
Practice Address - State:MD
Practice Address - Zip Code:21842-9522
Practice Address - Country:US
Practice Address - Phone:410-213-1233
Practice Address - Fax:410-213-1234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01333PT111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H498OtherCAREFIRST
T2490001OtherCAEFIRSTFEDERAL
658QMedicare UPIN
658QMedicare ID - Type Unspecified