MEDICARE: BRANCH CHIROPRACTIC SERVICES PC

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	X008267	NY

General Provider Information

NPI Number	:	1124330428
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRANCH CHIROPRACTIC SERVICES PC

Provider Business Mailing Address
First Line	:	900 WHEELER RD
Second Line	:	SUITE 265
City	:	HAUPPAUGE
State	:	NY
Zip	:	11788-2964
Country	:	US
Telephone Number	:	631-656-5656
Fax Number	:	631-361-2279

Provider Business Practice Location Address
First Line	:	900 WHEELER RD
Second Line	:	SUITE 265
City	:	HAUPPAUGE
State	:	NY
Zip	:	11788-2964
Country	:	US
Telephone Number	:	631-656-5656
Fax Number	:	631-361-2279

Authorized Official
Title or Position	:	PRES
Name	:	DR. THOMAS JOSEPH SCHUETTE
Credential	:	DC
Telephone Number	:	631-656-5656

Provider Enumeration Date	:	07/02/2010
Last Update Date	:	07/02/2010

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