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General NPI Number Information
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NPI Number | 1023366259
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Entity Type | Organization
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Legal Business Name | MORAN CHIROPRACTIC PC
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Dates
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Enumeration Date | 08/20/2012
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Last Update Date | 08/20/2012
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Provider Practice Location Address
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Address Line | 155 ROUTE 202
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City | SOMERS
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State | NY
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Zip | 10589-1604
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Country | US
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Telephone | 914-248-8555
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Fax | 914-248-8564
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Provider Business Mailing Address
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Address Line | 155 ROUTE 202
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City | SOMERS
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State | NY
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Zip | 10589-1604
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Country | US
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Telephone | 914-248-8555
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. THOMAS KEVIN MORAN
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Credential | D.C.
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Telephone | 914-248-8555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X003278-1
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License Number State | NY
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