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General NPI Number Information
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NPI Number | 1437398526
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Entity Type | Organization
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Legal Business Name | AM CHIROPRACTIC PC
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Dates
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Enumeration Date | 02/12/2009
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Last Update Date | 02/12/2009
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Provider Practice Location Address
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Address Line | 4 ARKANSAS AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10308-1502
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Country | US
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Telephone | 917-648-1005
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Fax |
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Provider Business Mailing Address
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Address Line | 4 ARKANSAS AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10308-1502
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Country | US
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Telephone | 917-648-1005
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALEXANDER MAZUROVSKY
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Credential | DC
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Telephone | 917-648-1005
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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 | X009550
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License Number State | NY
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