Healthcare Provider Details

I. General information

NPI: 1528489721
Provider Name (Legal Business Name): DR. BENJAMIN CARLOW CHIROPRACTOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2013
Last Update Date: 12/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 BARNUM AVE
PLAINVIEW NY
11803-5233
US

IV. Provider business mailing address

71 BARNUM AVE
PLAINVIEW NY
11803-5233
US

V. Phone/Fax

Practice location:
  • Phone: 516-993-9582
  • Fax:
Mailing address:
  • Phone: 516-993-9582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX012449-1
License Number StateNY

VII. Legacy identifiers

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

VIII. Authorized Official

Name: DR. BENJAMIN CARLOW
Title or Position: CHIROPRACTOR
Credential:
Phone: 516-993-9582