Healthcare Provider Details

I. General information

NPI: 1619248556
Provider Name (Legal Business Name): DEBORAH WEINSTOCK DC, PC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2012
Last Update Date: 02/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1069 OLD COUNTRY RD
PLAINVIEW NY
11803-4919
US

IV. Provider business mailing address

1069 OLD COUNTRY RD
PLAINVIEW NY
11803-4919
US

V. Phone/Fax

Practice location:
  • Phone: 516-932-5569
  • Fax: 516-932-7360
Mailing address:
  • Phone: 516-932-5569
  • Fax: 516-932-7360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX004795-1
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. DEBORAH WEINSTOCK
Title or Position: CHIROPRACTOR/OWNER
Credential: D.C.
Phone: 516-932-5569