Provider Demographics
NPI:1255570875
Name:QUEENS FAMILY CHIROPRACTIC PC
Entity type:Organization
Organization Name:QUEENS FAMILY CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:ROIT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:917-882-0239
Mailing Address - Street 1:55 NORTHERN BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-4058
Mailing Address - Country:US
Mailing Address - Phone:917-882-0239
Mailing Address - Fax:516-466-9353
Practice Address - Street 1:6241 WOODHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3731
Practice Address - Country:US
Practice Address - Phone:917-882-0239
Practice Address - Fax:516-466-9353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-05
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008526111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty