Provider Demographics
NPI:1255438511
Name:BOKOR, DANIEL PHILIP (DC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:PHILIP
Last Name:BOKOR
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 1:612 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-4631
Mailing Address - Country:US
Mailing Address - Phone:516-426-8419
Mailing Address - Fax:718-471-6542
Practice Address - Street 1:612 E BROADWAY
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-4631
Practice Address - Country:US
Practice Address - Phone:516-426-8419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX3580111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician