Healthcare Provider Details

I. General information

NPI: 1750932174
Provider Name (Legal Business Name): DIVINE CHIROPRACTIC AND ACUPUNCTURE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2019
Last Update Date: 09/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 CHURCH ST STE B
WHITE PLAINS NY
10601-1519
US

IV. Provider business mailing address

95 CHURCH ST STE B
WHITE PLAINS NY
10601-1519
US

V. Phone/Fax

Practice location:
  • Phone: 914-684-1800
  • Fax: 914-684-1801
Mailing address:
  • Phone: 914-684-1800
  • Fax: 914-684-1801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: KAREN SAID
Title or Position: OWNER
Credential: L.AC
Phone: 914-413-4263