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General NPI Number Information
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NPI Number | 1033350939
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Entity Type | Organization
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Legal Business Name | RP CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 03/23/2009
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Last Update Date | 03/23/2009
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Provider Practice Location Address
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Address Line | 9311 91ST AVE
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City | WOODHAVEN
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State | NY
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Zip | 11421-2745
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Country | US
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Telephone | 718-847-2326
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Fax |
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Provider Business Mailing Address
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Address Line | 9311 91ST AVE
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City | WOODHAVEN
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State | NY
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Zip | 11421-2745
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Country | US
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Telephone | 718-847-2326
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAYMOND PELLEGRINO
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Credential | D.C.
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Telephone | 516-385-1525
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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 | X008404
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License Number State | NY
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