Healthcare Provider Details

I. General information

NPI: 1720284185
Provider Name (Legal Business Name): HESKELL CHIROPRACTIC HEALING P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MILLER RD
FARMINGDALE NY
11735-2015
US

IV. Provider business mailing address

1 MILLER RD
FARMINGDALE NY
11735-2015
US

V. Phone/Fax

Practice location:
  • Phone: 516-755-5855
  • Fax:
Mailing address:
  • Phone: 516-755-5855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX010621
License Number StateNY

VIII. Authorized Official

Name: DR. HESKELL KHOZOURI-ZADEH
Title or Position: PRESIDENT
Credential: D.C.
Phone: 516-755-5855