Healthcare Provider Details

I. General information

NPI: 1841062403
Provider Name (Legal Business Name): NEW YORK CHIROPRACTIC FAMILY CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2023
Last Update Date: 12/05/2023
Certification Date: 10/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2052 RICHMOND RD
STATEN ISLAND NY
10306-2583
US

IV. Provider business mailing address

2052 RICHMOND RD
STATEN ISLAND NY
10306-2583
US

V. Phone/Fax

Practice location:
  • Phone: 718-667-2190
  • Fax: 718-667-7279
Mailing address:
  • Phone: 718-667-2190
  • Fax: 718-667-7279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: MR. FRANK MANDARINO
Title or Position: PROVIDER
Credential: DC
Phone: 917-750-5111