Provider Demographics
NPI:1205475357
Name:LEADING HEALTH CARE CHIROPRACTIC DIAGNOSTIC PC
Entity type:Organization
Organization Name:LEADING HEALTH CARE CHIROPRACTIC DIAGNOSTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YIGAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SASAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-688-5563
Mailing Address - Street 1:1091 E 36TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4825
Mailing Address - Country:US
Mailing Address - Phone:201-688-5563
Mailing Address - Fax:845-517-2427
Practice Address - Street 1:1091 E 36TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-4825
Practice Address - Country:US
Practice Address - Phone:201-688-5563
Practice Address - Fax:845-517-2427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty