Healthcare Provider Details

I. General information

NPI: 1245569011
Provider Name (Legal Business Name): GELBER FAMILY CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2009
Last Update Date: 08/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HICKSVILLE RD
MASSAPEQUA NY
11758-5823
US

IV. Provider business mailing address

100 HICKSVILLE RD
MASSAPEQUA NY
11758-5823
US

V. Phone/Fax

Practice location:
  • Phone: 516-799-5407
  • Fax:
Mailing address:
  • Phone: 516-799-5407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number70 011654
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number70 011721
License Number StateNY

VIII. Authorized Official

Name: SCOTT GELBER
Title or Position: PRESIDENT
Credential: DC
Phone: 516-799-5407