Healthcare Provider Details

I. General information

NPI: 1548576432
Provider Name (Legal Business Name): SYOSSET CHIROPRACTIC ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2010
Last Update Date: 08/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 JACKSON AVE
SYOSSET NY
11791-4124
US

IV. Provider business mailing address

332 JACKSON AVE
SYOSSET NY
11791-4124
US

V. Phone/Fax

Practice location:
  • Phone: 516-682-5050
  • Fax:
Mailing address:
  • Phone: 516-682-5050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ANTHONY M CONTE
Title or Position: PRESIDENT
Credential: DC
Phone: 516-682-5050