MEDICARE: MS. ANDREA OWENS DC

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	70-012562	NY

General Provider Information

NPI Number	:	1730548090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANDREA OWENS DC

Provider Business Mailing Address
First Line	:	8 W 38TH ST
Second Line	:	SUITE 1201
City	:	NEW YORK
State	:	NY
Zip	:	10018-6229
Country	:	US
Telephone Number	:	212-679-4221
Fax Number	:	212-679-4268

Provider Business Practice Location Address
First Line	:	8 W 38TH ST
Second Line	:	SUITE 1201
City	:	NEW YORK
State	:	NY
Zip	:	10018-6229
Country	:	US
Telephone Number	:	212-679-4221
Fax Number	:	212-679-4268

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2016
Last Update Date	:	02/15/2016

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