Provider Demographics
NPI:1720491194
Name:SOLTANOFF CHIROPRACTIC
Entity Type:Organization
Organization Name:SOLTANOFF CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLTANOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:845-331-0300
Mailing Address - Street 1:324 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-4470
Mailing Address - Country:US
Mailing Address - Phone:845-331-0300
Mailing Address - Fax:
Practice Address - Street 1:324 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-4470
Practice Address - Country:US
Practice Address - Phone:845-331-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty