Healthcare Provider Details

I. General information

NPI: 1588094791
Provider Name (Legal Business Name): GEULA CHIROPRACTIC CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2013
Last Update Date: 11/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 MIDDLE NECK RD
GREAT NECK NY
11021-1136
US

IV. Provider business mailing address

212 MIDDLE NECK RD
GREAT NECK NY
11021-1136
US

V. Phone/Fax

Practice location:
  • Phone: 516-466-3951
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: ALBERT YOUSSEFI
Title or Position: DC
Credential:
Phone: 516-466-3951