Provider Demographics
NPI:1720292014
Name:JASON S. BRATTNER, DC, PC
Entity Type:Organization
Organization Name:JASON S. BRATTNER, DC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:S
Authorized Official - Last Name:BRATTNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-541-9296
Mailing Address - Street 1:1272 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-2304
Mailing Address - Country:US
Mailing Address - Phone:718-667-2190
Mailing Address - Fax:718-667-7279
Practice Address - Street 1:1272 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-2304
Practice Address - Country:US
Practice Address - Phone:718-667-2190
Practice Address - Fax:718-667-7279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008612111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU71543Medicare UPIN
NYXYW831Medicare PIN