Provider Demographics
NPI:1881983609
Name:WELLSTATE CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:WELLSTATE CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FEODOR
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAKATCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:212-213-6158
Mailing Address - Street 1:347 5TH AVE
Mailing Address - Street 2:SUITE 1300
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5010
Mailing Address - Country:US
Mailing Address - Phone:212-213-6158
Mailing Address - Fax:212-529-7258
Practice Address - Street 1:347 5TH AVE
Practice Address - Street 2:SUITE 1300
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5010
Practice Address - Country:US
Practice Address - Phone:212-213-6158
Practice Address - Fax:212-529-7258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011876111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty