Healthcare Provider Details

I. General information

NPI: 1457620049
Provider Name (Legal Business Name): AGUILAR CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2011
Last Update Date: 01/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5030 BROADWAY SUITE 642
NEW YORK NY
10034-1609
US

IV. Provider business mailing address

5030 BROADWAY SUITE 642
NEW YORK NY
10034-1609
US

V. Phone/Fax

Practice location:
  • Phone: 646-524-7696
  • Fax: 646-524-7697
Mailing address:
  • Phone: 646-524-7696
  • Fax: 646-524-7697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberX011576
License Number StateNY

VIII. Authorized Official

Name: DR. DAVID EMIL AGUILAR
Title or Position: PRESIDENT
Credential: DC, DACNB
Phone: 646-524-7696