Healthcare Provider Details

I. General information

NPI: 1083968275
Provider Name (Legal Business Name): KAHN CHIROPRACTIC-CERTIFIED DIETITION NUTRITIONIST PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2012
Last Update Date: 11/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 WARREN ST GROUND FLOOR
NEW YORK NY
10007-3509
US

IV. Provider business mailing address

51 WARREN ST GROUND FLOOR
NEW YORK NY
10007-3509
US

V. Phone/Fax

Practice location:
  • Phone: 212-374-0102
  • Fax: 212-513-1618
Mailing address:
  • Phone: 212-374-0102
  • Fax: 212-513-1618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number70007392
License Number StateNY

VIII. Authorized Official

Name: DR. MITCHELL H KAHN
Title or Position: DOCTOR
Credential: D.C.
Phone: 845-300-5538