Healthcare Provider Details

I. General information

NPI: 1053810259
Provider Name (Legal Business Name): ALIGN CHIROPRACTIC WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2018
Last Update Date: 03/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

493 ROUTE 304
NEW CITY NY
10956-3036
US

IV. Provider business mailing address

493 ROUTE 304
NEW CITY NY
10956-3036
US

V. Phone/Fax

Practice location:
  • Phone: 845-634-0621
  • Fax:
Mailing address:
  • Phone: 845-634-0621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number StateNY

VIII. Authorized Official

Name: DR. ROBERT K GREGORY
Title or Position: OWNER
Credential: DC
Phone: 845-596-6761