Provider Demographics
NPI:1932232113
Name:QUEENS CHIROPRACTIC PC
Entity Type:Organization
Organization Name:QUEENS CHIROPRACTIC PC
Other - Org Name:QUEENS CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:KLAPPER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-263-0055
Mailing Address - Street 1:7112 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2015
Mailing Address - Country:US
Mailing Address - Phone:718-263-0055
Mailing Address - Fax:718-263-0578
Practice Address - Street 1:7112 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-2015
Practice Address - Country:US
Practice Address - Phone:718-263-0055
Practice Address - Fax:718-263-0578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX002970-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01730670Medicaid
NYT31929Medicare UPIN
NY01730670Medicaid