Provider Demographics
NPI:1205094067
Name:S A HEALTHY BODY CHIROPRACTIC
Entity type:Organization
Organization Name:S A HEALTHY BODY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CHIROPRACTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:ALBERT
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:718-698-5600
Mailing Address - Street 1:271 KELLY BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6008
Mailing Address - Country:US
Mailing Address - Phone:718-698-5600
Mailing Address - Fax:718-698-5668
Practice Address - Street 1:271 KELLY BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6008
Practice Address - Country:US
Practice Address - Phone:718-698-5600
Practice Address - Fax:718-698-5668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008514111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty