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General NPI Number Information
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NPI Number | 1295190627
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Entity Type | Organization
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Legal Business Name | APAK CHIROPRACTIC
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Dates
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Enumeration Date | 12/30/2015
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Last Update Date | 12/30/2015
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Provider Practice Location Address
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Address Line | 218-02 HEMPSTEAD AVENUE 2ND FLOOR
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City | QUEENS VILLAGE
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State | NY
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Zip | 11429
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Country | US
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Telephone | 718-749-5308
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Fax |
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Provider Business Mailing Address
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Address Line | 21802 HEMPSTEAD AVE 2ND FLOOR
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City | QUEENS VILLAGE
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State | NY
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Zip | 11429-1235
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Country | US
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Telephone | 718-749-5308
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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. ALEKSANDR MOSTOVOY
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Credential | DC
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Telephone | 718-749-5308
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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 | 010194
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License Number State | NY
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