Healthcare Provider Details

I. General information

NPI: 1285783795
Provider Name (Legal Business Name): TOUCH OF LIFE CHIROPRACTIC EAST PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 12/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

581 MONTAUK HWY
EASTPORT NY
11941-1128
US

IV. Provider business mailing address

581 MONTAUK HWY
EASTPORT NY
11941-1128
US

V. Phone/Fax

Practice location:
  • Phone: 631-874-2797
  • Fax: 631-874-9387
Mailing address:
  • Phone: 631-874-2797
  • Fax: 631-874-9387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX007341
License Number StateNY

VIII. Authorized Official

Name: DR. STUART JAY MENIS
Title or Position: PRESIDENT
Credential: D.C.
Phone: 631-874-2797