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General NPI Number Information
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NPI Number | 1851751838
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Entity Type | Organization
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Legal Business Name | MANHASSET CHIROPRACTIC PC
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Dates
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Enumeration Date | 03/03/2016
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Last Update Date | 03/03/2016
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Provider Practice Location Address
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Address Line | 560 NORTHERN BLVD STE 106B
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City | GREAT NECK
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State | NY
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Zip | 11021-5118
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Country | US
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Telephone | 516-466-6164
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Fax | 516-304-5712
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Provider Business Mailing Address
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Address Line | 560 NORTHERN BLVD STE 106B
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City | GREAT NECK
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State | NY
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Zip | 11021-5118
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Country | US
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Telephone | 516-466-6164
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. GARRETT ILG REICHELT
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Credential | D.C.
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Telephone | 631-682-1544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition 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 | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 111NX0100X
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Taxonomy Name | Occupational Health Chiropractor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number |
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License Number State |
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