Healthcare Provider Details

I. General information

NPI: 1396947016
Provider Name (Legal Business Name): GLENN H WHITNEY, D.C.,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 10/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

279 SUNRISE HWY
ROCKVILLE CENTRE NY
11570-4925
US

IV. Provider business mailing address

PO BOX 461
ROCKVILLE CENTRE NY
11571-0461
US

V. Phone/Fax

Practice location:
  • Phone: 516-594-1900
  • Fax: 516-594-1973
Mailing address:
  • Phone: 516-594-1900
  • Fax: 516-594-1973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX008858
License Number StateNY

VIII. Authorized Official

Name: DR. GLENN HOWARD WHITNEY
Title or Position: PRESIDENT
Credential: D.C.
Phone: 516-594-1900