Provider Demographics
NPI:1669585667
Name:ZOMICK, ANDREW MICHAEL (DC)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:MICHAEL
Last Name:ZOMICK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 BRADFORD ST
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-2624
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:61 BROADWAY
Practice Address - Street 2:SUITE 900
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10006-2701
Practice Address - Country:US
Practice Address - Phone:212-248-0077
Practice Address - Fax:212-747-0939
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011097111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor