Healthcare Provider Details

I. General information

NPI: 1881381168
Provider Name (Legal Business Name): MANDARINO CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9705 3RD AVE
BROOKLYN NY
11209-7702
US

IV. Provider business mailing address

9705 3RD AVE
BROOKLYN NY
11209-7702
US

V. Phone/Fax

Practice location:
  • Phone: 718-748-9624
  • Fax: 929-345-2074
Mailing address:
  • Phone: 718-748-9624
  • Fax: 929-345-2074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: FRANK JOSEPH MANDARINO
Title or Position: OWNER
Credential: DC
Phone: 917-750-5111