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General NPI Number Information
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NPI Number | 1134928849
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Entity Type | Organization
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Legal Business Name | WEST ISLIP CHIROPRACTIC, PHYSICAL THERAPY, ACUPUNCTURE, AND ADULT HEALTH NP, PLLC
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 786 MONTAUK HWY UPPR LEVEL
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City | WEST ISLIP
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State | NY
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Zip | 11795-4926
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Country | US
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Telephone | 631-661-1400
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Fax | 631-661-5242
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Provider Business Mailing Address
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Address Line | 786 MONTAUK HWY UPPR LEVEL
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City | WEST ISLIP
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State | NY
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Zip | 11795-4926
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Country | US
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Telephone | 631-661-1400
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Fax | 631-661-5242
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Authorized Official
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Title or Position | OWNER
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Name | DR. GERARD J SMITH
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Credential | DC
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Telephone | 631-661-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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