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General NPI Number Information
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NPI Number | 1922268689
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Entity Type | Organization
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Legal Business Name | LOUCA CHIROPRACTIC PC
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Dates
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Enumeration Date | 06/16/2008
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 1879 BELLMORE AVE
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City | NORTH BELLMORE
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State | NY
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Zip | 11710-5551
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Country | US
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Telephone | 516-221-9336
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Fax | 516-221-8842
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Provider Business Mailing Address
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Address Line | 1879 BELLMORE AVE
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City | NORTH BELLMORE
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State | NY
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Zip | 11710-5551
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Country | US
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Telephone | 516-221-9336
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Fax | 516-221-8842
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Authorized Official
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Title or Position | CEO/DOCTOR
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Name | DR. ONISIS LOUCA
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Credential | DC
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Telephone | 516-221-9336
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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 | X007901
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License Number State | NY
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