Healthcare Provider Details

I. General information

NPI: 1952573065
Provider Name (Legal Business Name): NEW YORK CHIROPRACTIC & PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2008
Last Update Date: 11/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1163 FOREST AVE
STATEN ISLAND NY
10310-2408
US

IV. Provider business mailing address

1163 FOREST AVE
STATEN ISLAND NY
10310-2408
US

V. Phone/Fax

Practice location:
  • Phone: 718-727-0055
  • Fax: 718-727-3020
Mailing address:
  • Phone: 718-727-0055
  • Fax: 718-727-3020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN P PIAZZA
Title or Position: PRESIDENT
Credential: DC
Phone: 718-727-0055