Healthcare Provider Details

I. General information

NPI: 1023442936
Provider Name (Legal Business Name): NEW HEIGHTS CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2013
Last Update Date: 08/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 W 181ST ST
NEW YORK NY
10033-4543
US

IV. Provider business mailing address

812 W 181ST ST
NEW YORK NY
10033-4543
US

V. Phone/Fax

Practice location:
  • Phone: 212-928-3300
  • Fax:
Mailing address:
  • Phone: 212-928-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number008387
License Number StateNY

VIII. Authorized Official

Name: STEVEN GEANOPULOS
Title or Position: PRESIDENT
Credential: DC
Phone: 212-928-3300