Healthcare Provider Details

I. General information

NPI: 1427153972
Provider Name (Legal Business Name): TRI STATE CHIROPRACTIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

665 PELHAM PKWY N SUITE 2C
BRONX NY
10467-8068
US

IV. Provider business mailing address

665 PELHAM PKWY N SUITE 2C
BRONX NY
10467-8068
US

V. Phone/Fax

Practice location:
  • Phone: 718-231-1877
  • Fax: 718-231-1501
Mailing address:
  • Phone: 718-231-1877
  • Fax: 718-231-1501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number008837
License Number StateNY

VIII. Authorized Official

Name: PETER D. ALBIS
Title or Position: OWNER
Credential: D.C.
Phone: 718-231-1877