Provider Demographics
NPI:1831516053
Name:MEISSNER CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:MEISSNER CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELIQUE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MEISSNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:646-286-3207
Mailing Address - Street 1:1911 RICHMOND AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-3913
Mailing Address - Country:US
Mailing Address - Phone:718-982-6496
Mailing Address - Fax:917-791-8833
Practice Address - Street 1:1911 RICHMOND AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3913
Practice Address - Country:US
Practice Address - Phone:718-982-6496
Practice Address - Fax:917-791-8833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012314111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty