Provider Demographics
NPI:1386177764
Name:ENCORE CHIROPRACTIC P.C.
Entity type:Organization
Organization Name:ENCORE CHIROPRACTIC P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:POOLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:646-518-8696
Mailing Address - Street 1:131 E 61ST ST
Mailing Address - Street 2:ENCORE CHIROPRACTIC
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8115
Mailing Address - Country:US
Mailing Address - Phone:646-518-8696
Mailing Address - Fax:
Practice Address - Street 1:131 E 61ST ST
Practice Address - Street 2:ENCORE CHIROPRACTIC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8115
Practice Address - Country:US
Practice Address - Phone:646-518-8696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX012631111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty