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General NPI Number Information
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NPI Number | 1881824308
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Entity Type | Organization
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Legal Business Name | NYC CHIROPRACTIC PHYSICAL THERAPY, ACU
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Dates
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Enumeration Date | 07/17/2009
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 150 BROADWAY SUITE 1115
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City | NEW YORK
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State | NY
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Zip | 10038
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Country | US
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Telephone | 212-962-2262
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Fax | 646-607-4412
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Provider Business Mailing Address
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Address Line | 150 BROADWAY SUITE 1115
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City | NEW YORK
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State | NY
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Zip | 10038
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Country | US
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Telephone | 212-962-2262
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Fax | 646-607-4412
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Authorized Official
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Title or Position | PARTNER
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Name | DR. RANDY R STEPHAN
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Credential | DC
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Telephone | 212-962-2262
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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 | X008751
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 032554
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License Number State | NY
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