Healthcare Provider Details

I. General information

NPI: 1699916361
Provider Name (Legal Business Name): CHRISTINE ANN VLACHOS DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2009
Last Update Date: 09/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 ROUTE 202
SOMERS NY
10589
US

IV. Provider business mailing address

746B HERITAGE HLS
SOMERS NY
10589-4008
US

V. Phone/Fax

Practice location:
  • Phone: 914-276-3030
  • Fax: 914-471-8339
Mailing address:
  • Phone: 914-486-3001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX008726
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX008726-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: