MEDICARE: SOUTH SHORE CHIROPRACTIC, PLLC

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	X008879	NY

General Provider Information

NPI Number	:	1871613794
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH SHORE CHIROPRACTIC, PLLC

Provider Business Mailing Address
First Line	:	321 EDISON ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-3023
Country	:	US
Telephone Number	:	718-967-4646
Fax Number	:	718-966-4382

Provider Business Practice Location Address
First Line	:	321 EDISON ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-3023
Country	:	US
Telephone Number	:	718-967-4646
Fax Number	:	718-966-4382

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. MATTHEW HOOVIS
Credential	:	D.C.
Telephone Number	:	718-967-4646

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	01/08/2026

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