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General NPI Number Information
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NPI Number | 1508254178
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Entity Type | Organization
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Legal Business Name | SPINE FIRST CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 01/05/2015
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Last Update Date | 01/05/2015
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Provider Practice Location Address
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Address Line | 615 SENECA AVE GROUND FLOOR (MEDICAL CENTER)
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City | RIDGEWOOD
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State | NY
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Zip | 11385-2170
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Country | US
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Telephone | 718-497-9768
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Fax |
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Provider Business Mailing Address
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Address Line | 615 SENECA AVE GROUND FLOOR (MEDICAL CENTER)
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City | RIDGEWOOD
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State | NY
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Zip | 11385-2170
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Country | US
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Telephone | 718-497-9768
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DR. HOMAN YEUNG
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Credential | D.C.
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Telephone | 347-681-2110
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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 | X0120581
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License Number State | NY
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