Healthcare Provider Details

I. General information

NPI: 1295019172
Provider Name (Legal Business Name): ESPRIT CHIROPRACTIC & PHYSICAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2011
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 W 119TH STREET
NEW YORK NY
10026
US

IV. Provider business mailing address

34 W 119TH STREET
NEW YORK NY
10026
US

V. Phone/Fax

Practice location:
  • Phone: 212-354-2020
  • Fax: 347-230-6265
Mailing address:
  • Phone: 212-354-2020
  • Fax: 347-230-6265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08634
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number033603
License Number StateNY

VIII. Authorized Official

Name: DR. AATIF M SIDDIQUI
Title or Position: PRESIDENT
Credential: D.C.
Phone: 212-354-2020