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General NPI Number Information
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NPI Number | 1578892121
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Entity Type | Organization
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Legal Business Name | SASAN FAMILY CHIROPRACTIC P.C
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Dates
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Enumeration Date | 12/10/2009
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Last Update Date | 12/10/2009
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Provider Practice Location Address
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Address Line | 8717 21ST AVE STE BASEMENT
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City | BROOKLYN
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State | NY
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Zip | 11214-4951
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Country | US
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Telephone | 718-219-2322
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Fax |
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Provider Business Mailing Address
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Address Line | 8717 21ST AVE STE BASEMENT
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City | BROOKLYN
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State | NY
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Zip | 11214-4951
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Country | US
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Telephone | 718-219-2322
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | YIGAL SASAN
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Credential | D.C
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Telephone | 718-219-2322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 38MC00675600
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | X011725
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License Number State | NY
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