Provider Demographics
NPI:1932399532
Name:DYKER HEIGHTS FAMILY CHIROPRACTOR
Entity Type:Organization
Organization Name:DYKER HEIGHTS FAMILY CHIROPRACTOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:BAUDILLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-837-0048
Mailing Address - Street 1:7301 NEW UTRECHT AVENUE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204
Mailing Address - Country:US
Mailing Address - Phone:718-837-0048
Mailing Address - Fax:718-837-7145
Practice Address - Street 1:7301 NEW UTRECHT AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-5137
Practice Address - Country:US
Practice Address - Phone:718-837-0048
Practice Address - Fax:718-837-7145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0045021111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty