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General NPI Number Information
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NPI Number | 1922663095
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Entity Type | Individual
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Provider Name | ZACHARY ALEXANDER NOWICKI DC
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Gender | Male
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Dates
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Enumeration Date | 05/04/2019
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 369 E MAIN ST STE 6
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City | EAST ISLIP
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State | NY
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Zip | 11730-2800
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Country | US
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Telephone | 631-968-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 12 AMBOY LN
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City | LAKE GROVE
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State | NY
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Zip | 11755-2502
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Country | US
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Telephone | 631-418-6378
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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 | X013155
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 013155
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License Number State | NY
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