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General NPI Number Information
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NPI Number | 1194240374
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Entity Type | Organization
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Legal Business Name | BROOKLYN SPINE AND JOINT CHIROPRACTIC, PT REHAB AND ACUPUNCTURE PLLC
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Dates
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Enumeration Date | 08/08/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2019 NOSTRAND AVE
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City | BROOKLYN
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State | NY
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Zip | 11210-2549
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Country | US
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Telephone | 914-261-7534
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Fax |
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Provider Business Mailing Address
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Address Line | 2019 NOSTRAND AVE
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City | BROOKLYN
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State | NY
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Zip | 11210-2549
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Country | US
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Telephone | 914-261-7534
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. ROBERT REISS
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Credential | DC
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Telephone | 914-261-7534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | NYSX24342
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License Number State | NY
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