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General NPI Number Information
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NPI Number | 1407978489
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Entity Type | Organization
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Legal Business Name | SUFFOLK FAMILY CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4322 50TH ST SUITE 1-B
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City | WOODSIDE
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State | NY
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Zip | 11377-4442
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Country | US
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Telephone | 718-424-4455
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Fax | 718-478-8672
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Provider Business Mailing Address
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Address Line | 4322 50TH ST SUITE 1-B
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City | WOODSIDE
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State | NY
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Zip | 11377-4442
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Country | US
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Telephone | 718-424-4455
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Fax | 718-478-8672
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN FERNANDEZ
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Credential | D.C.
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Telephone | 718-424-4455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NI0013X
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Taxonomy Name | Independent Medical Examiner Chiropractor
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License Number | C-007735-6B
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number | C-007735-6B
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | C-007735-6B
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number | C-007735-6B
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License Number State | NY
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