Provider Demographics
NPI:1801927520
Name:IRBY, ARCHER LEWIS (DC)
Entity type:Individual
Prefix:DR
First Name:ARCHER
Middle Name:LEWIS
Last Name:IRBY
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 1:1336 UTICA AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-5912
Mailing Address - Country:US
Mailing Address - Phone:347-766-0598
Mailing Address - Fax:212-202-4878
Practice Address - Street 1:1336 UTICA AVE FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-5912
Practice Address - Country:US
Practice Address - Phone:347-766-0598
Practice Address - Fax:212-202-4878
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3114111N00000X, 111N00000X
NYX010162111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY134184144-003OtherUNITEDHEALTHCARE
NYX.4V971OtherBCBS
NYX62A61OtherEMPIRE BCBS
NYP2646703OtherOXFORD
NY5806764OtherGHI
NJ116581W5PMedicare PIN