Healthcare Provider Details

I. General information

NPI: 1457244980
Provider Name (Legal Business Name): CROSS COUNTY CHIROPRACTIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

12911 MERRICK BLVD
JAMAICA NY
11434-3425
US

IV. Provider business mailing address

PO BOX 461
ROCKVILLE CENTRE NY
11571-0461
US

V. Phone/Fax

Practice location:
  • Phone: 516-594-1900
  • Fax: 516-594-1973
Mailing address:
  • Phone: 516-594-1900
  • Fax: 516-594-1973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. GLENN H WHITNEY
Title or Position: PRESIDENT/OWNER
Credential: D.C.
Phone: 516-594-1900