Provider Demographics
NPI:1780888925
Name:POJERO FAMILY CHIROPRACTIC PC
Entity type:Organization
Organization Name:POJERO FAMILY CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CHIROPRACTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:POJERO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:631-244-0300
Mailing Address - Street 1:153 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11782-2503
Mailing Address - Country:US
Mailing Address - Phone:631-244-0300
Mailing Address - Fax:631-244-5608
Practice Address - Street 1:153 MAIN ST
Practice Address - Street 2:
Practice Address - City:SAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11782-2503
Practice Address - Country:US
Practice Address - Phone:631-244-0300
Practice Address - Fax:631-244-5608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008672111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU69953Medicare UPIN
NYX4A071Medicare ID - Type UnspecifiedCHIROPRACTIC