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General NPI Number Information
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NPI Number | 1841024171
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Entity Type | Organization
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Legal Business Name | DEER PARK CHIROPRACTIC AND PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 08/29/2024
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 1848 DEER PARK AVE
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City | DEER PARK
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State | NY
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Zip | 11729-4318
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Country | US
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Telephone | 631-502-0008
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Fax | 516-605-2203
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Provider Business Mailing Address
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Address Line | 1848 DEER PARK AVE
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City | DEER PARK
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State | NY
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Zip | 11729-4318
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Country | US
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Telephone | 631-502-0008
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Fax | 631-502-0009
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Authorized Official
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Title or Position | MEMBER
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Name | ANNIE JOSEPH
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Credential | PT
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Telephone | 631-885-3831
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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