Provider Demographics
NPI:1952597197
Name:ERIC I DEGIS, DC, PC
Entity Type:Organization
Organization Name:ERIC I DEGIS, DC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:I
Authorized Official - Last Name:DEGIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:212-253-7347
Mailing Address - Street 1:920 BROADWAY
Mailing Address - Street 2:SUITE 703
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-6004
Mailing Address - Country:US
Mailing Address - Phone:212-253-7347
Mailing Address - Fax:212-253-7301
Practice Address - Street 1:920 BROADWAY
Practice Address - Street 2:SUITE 703
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6004
Practice Address - Country:US
Practice Address - Phone:212-253-7347
Practice Address - Fax:212-253-7301
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ERIC I DEGIS, DC, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-21
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008656-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWX5181Medicare PIN