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General NPI Number Information
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NPI Number | 1396985065
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Entity Type | Organization
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Legal Business Name | UNIQUE CHIROPRACTIC PC
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Dates
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Enumeration Date | 02/20/2009
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Last Update Date | 02/20/2009
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Provider Practice Location Address
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Address Line | 1 MAIDEN LN FL 4
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City | NEW YORK
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State | NY
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Zip | 10038-5130
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Country | US
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Telephone | 212-791-3399
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Fax | 212-791-3388
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Provider Business Mailing Address
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Address Line | 1 MAIDEN LN FL 4
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City | NEW YORK
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State | NY
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Zip | 10038-5130
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Country | US
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Telephone | 212-791-3399
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Fax | 212-791-3388
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Authorized Official
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Title or Position | OWNER
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Name | DR. DIANA VAVIKOVA
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Credential | DC
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Telephone | 212-791-3399
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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 | X009246
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License Number State | NY
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