Healthcare Provider Details
I. General information
NPI: 1306016092
Provider Name (Legal Business Name): OSSINING CHIROPRACTIC OFFICE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/10/2008
Last Update Date: 01/10/2020
Certification Date: 01/10/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
71 CROTON AVE
OSSINING NY
10562-4903
US
IV. Provider business mailing address
71 CROTON AVE
OSSINING NY
10562-4903
US
V. Phone/Fax
- Phone: 914-941-1141
- Fax: 914-941-1141
- Phone: 914-941-1141
- Fax: 914-941-1141
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | X0081971 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RICHARD
LOUIS
FINEWOOD
Title or Position: OWNER
Credential:
Phone: 914-941-1141