Provider Demographics
NPI:1295709889
Name:NEW DORP CHIROPRACTIC ASSOCIATES
Entity type:Organization
Organization Name:NEW DORP CHIROPRACTIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:VERRILLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-987-2408
Mailing Address - Street 1:3077 HYLAN BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-4154
Mailing Address - Country:US
Mailing Address - Phone:718-987-2408
Mailing Address - Fax:718-987-9240
Practice Address - Street 1:3077 HYLAN BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-4154
Practice Address - Country:US
Practice Address - Phone:718-987-2408
Practice Address - Fax:718-987-9240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
X2W131Medicare PIN