Provider Demographics
NPI:1932274552
Name:GIERSBERG, CHARLES JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:JOHN
Last Name:GIERSBERG
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 1:293 CASTLE AVE
Mailing Address - Street 2:SUITE 1E
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-2025
Mailing Address - Country:US
Mailing Address - Phone:516-280-3970
Mailing Address - Fax:516-280-3970
Practice Address - Street 1:293 CASTLE AVE
Practice Address - Street 2:SUITE 1E
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-2025
Practice Address - Country:US
Practice Address - Phone:516-280-3970
Practice Address - Fax:516-280-3970
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004348111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor