Healthcare Provider Details

I. General information

NPI: 1669286837
Provider Name (Legal Business Name): DAVID ATLAS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2025
Last Update Date: 02/06/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 HORSEBLOCK ROAD
FARMINGVILLE NY
11738
US

IV. Provider business mailing address

700 HORSEBLOCK ROAD
FARMINGVILLE NY
11738
US

V. Phone/Fax

Practice location:
  • Phone: 631-732-1386
  • Fax: 631-732-1544
Mailing address:
  • Phone: 631-732-1386
  • Fax: 631-732-1544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number013845
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: