Provider Demographics
NPI:1134928849
Name:WEST ISLIP CHIROPRACTIC, PHYSICAL THERAPY, ACUPUNCTURE, AND ADULT HEAL
Entity type:Organization
Organization Name:WEST ISLIP CHIROPRACTIC, PHYSICAL THERAPY, ACUPUNCTURE, AND ADULT HEAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:631-661-1400
Mailing Address - Street 1:786 MONTAUK HWY UPPR LEVEL
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4926
Mailing Address - Country:US
Mailing Address - Phone:631-661-1400
Mailing Address - Fax:631-661-5242
Practice Address - Street 1:786 MONTAUK HWY UPPR LEVEL
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4926
Practice Address - Country:US
Practice Address - Phone:631-661-1400
Practice Address - Fax:631-661-5242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty