Healthcare Provider Details

I. General information

NPI: 1518024496
Provider Name (Legal Business Name): PHILIP MARC EPSTEIN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 03/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 DOROTHEA ST
PLAINVIEW NY
11803-6211
US

IV. Provider business mailing address

1 DOROTHEA ST
PLAINVIEW NY
11803-6211
US

V. Phone/Fax

Practice location:
  • Phone: 516-932-1616
  • Fax: 516-932-1632
Mailing address:
  • Phone: 516-932-1616
  • Fax: 516-932-1632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX006594-1
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: