MEDICARE: METROTECH CHIROPRACTIC OFFICE P C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CO9051-6	NY

General Provider Information

NPI Number	:	1063773745
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METROTECH CHIROPRACTIC OFFICE P C

Provider Business Mailing Address
First Line	:	50 COURT ST STE 511
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-4848
Country	:	US
Telephone Number	:	718-237-5117
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 COURT ST STE 511
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-4848
Country	:	US
Telephone Number	:	718-237-5117
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. JONATHAN SPITZ
Credential	:
Telephone Number	:	718-237-5117

Provider Enumeration Date	:	05/30/2012
Last Update Date	:	02/24/2014

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