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General NPI Number Information
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NPI Number | 1699837195
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Entity Type | Organization
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Legal Business Name | ALBANY CENTRAL CHIROPRACTIC
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 06/12/2008
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Provider Practice Location Address
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Address Line | 879 MADISON AVE
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City | ALBANY
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State | NY
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Zip | 12208-3321
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Country | US
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Telephone | 518-465-3331
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Fax | 518-462-6697
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Provider Business Mailing Address
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Address Line | 879 MADISON AVE
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City | ALBANY
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State | NY
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Zip | 12208-3321
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Country | US
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Telephone | 518-465-3331
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Fax | 518-462-6697
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Authorized Official
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Title or Position | OWNER PRACTITIONER
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Name | DR. MICHAEL NICHOLAS BERNHARDT
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Credential | D.C.
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Telephone | 518-465-3331
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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 | X3206
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License Number State | NY
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