Healthcare Provider Details

I. General information

NPI: 1013090927
Provider Name (Legal Business Name): DJM CHIROPRACTIC P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 08/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 NEPTUNE AVE
BROOKLYN NY
11235-6845
US

IV. Provider business mailing address

308 NEPTUNE AVE
BROOKLYN NY
11235-6845
US

V. Phone/Fax

Practice location:
  • Phone: 718-615-0800
  • Fax:
Mailing address:
  • Phone: 718-758-5558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number010331
License Number StateNY

VIII. Authorized Official

Name: JEFF FRIEDMAN
Title or Position: OWNER
Credential: DC
Phone: 718-615-0800