Provider Demographics
NPI:1205921350
Name:WORKIN, ERIC (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:WORKIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 SOUTH AVE STE 26
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-3403
Mailing Address - Country:US
Mailing Address - Phone:347-273-1330
Mailing Address - Fax:718-815-7363
Practice Address - Street 1:25 VICTORY BLVD FL 2
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-2905
Practice Address - Country:US
Practice Address - Phone:718-815-7246
Practice Address - Fax:718-815-7363
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00628000111N00000X
NYX008373-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0091227Medicaid
U64762Medicare UPIN
NJ0091227Medicaid