Provider Demographics
NPI:1396827556
Name:GOODHEART, ZATKIN, HACK & ASSOCIATES
Entity type:Organization
Organization Name:GOODHEART, ZATKIN, HACK & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HACK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:313-881-0662
Mailing Address - Street 1:20567 MACK AVE
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-1655
Mailing Address - Country:US
Mailing Address - Phone:313-881-0662
Mailing Address - Fax:
Practice Address - Street 1:20567 MACK AVE
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE WOODS
Practice Address - State:MI
Practice Address - Zip Code:48236-1655
Practice Address - Country:US
Practice Address - Phone:313-881-0662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950Q24600OtherBLUE CROSS/BLUE SHIELD
MI0Q24600Medicare ID - Type UnspecifiedMEDICARE NUMBER