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General NPI Number Information
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NPI Number | 1891469243
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Entity Type | Individual
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Provider Name | TERESA NICOLE BRINK DC
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Gender | Female
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Dates
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Enumeration Date | 08/08/2021
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Last Update Date | 08/08/2021
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Provider Practice Location Address
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Address Line | 301 HEMPSTEAD AVE
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City | MALVERNE
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State | NY
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Zip | 11565-1225
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Country | US
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Telephone | 516-505-0755
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Fax |
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Provider Business Mailing Address
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Address Line | 131 CEDAR RD
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City | EAST NORTHPORT
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State | NY
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Zip | 11731-4339
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Country | US
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Telephone | 631-603-8990
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | X013486
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License Number State | NY
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