Provider Demographics
NPI:1457416711
Name:ALL ISLAND CHIROPRACTIC CARE, P.C.
Entity Type:Organization
Organization Name:ALL ISLAND CHIROPRACTIC CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:SELZER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:631-665-3714
Mailing Address - Street 1:56 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8327
Mailing Address - Country:US
Mailing Address - Phone:631-665-3714
Mailing Address - Fax:631-665-3749
Practice Address - Street 1:56 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8327
Practice Address - Country:US
Practice Address - Phone:631-665-3714
Practice Address - Fax:631-665-3749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007836111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX5B921Medicare ID - Type Unspecified