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General NPI Number Information
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NPI Number | 1588103899
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE CHIROPRACTIC CENTER
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Dates
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Enumeration Date | 02/20/2017
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Last Update Date | 02/22/2017
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Provider Practice Location Address
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Address Line | 2854 LOWER LINCOLN AVE
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City | OCEANSIDE
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State | NY
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Zip | 11572-2117
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Country | US
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Telephone | 516-766-8092
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Fax | 516-763-0733
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Provider Business Mailing Address
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Address Line | 2854 LOWER LINCOLN AVE
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City | OCEANSIDE
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State | NY
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Zip | 11572-2117
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Country | US
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Telephone | 516-766-8092
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Fax | 516-763-0733
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY A SHAPIRO
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Credential | DC
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Telephone | 516-766-8092
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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 | X005198
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License Number State | NY
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