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General NPI Number Information
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NPI Number | 1154446540
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Entity Type | Individual
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Provider Name | RAYMOND I JAGHAB DC
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Gender | Male
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 300 HEMPSTEAD TPKE
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City | WEST HEMPSTEAD
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State | NY
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Zip | 11552-1450
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Country | US
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Telephone | 516-481-3091
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Fax | 516-481-0269
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Provider Business Mailing Address
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Address Line | 8 RYDER CT
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City | DIX HILLS
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State | NY
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Zip | 11746-6142
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Country | US
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Telephone | 631-586-2731
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Fax | 516-481-0269
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | X004940-1
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License Number State | NY
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