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General NPI Number Information
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NPI Number | 1932330412
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Entity Type | Organization
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Legal Business Name | KOLLEL CHIROPRACTIC CARE PC
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Dates
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Enumeration Date | 08/03/2009
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Last Update Date | 06/29/2012
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Provider Practice Location Address
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Address Line | 230 MIDDLE NECK RD STE 1
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City | GREAT NECK
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State | NY
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Zip | 11021-1113
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Country | US
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Telephone | 516-466-2585
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Fax | 516-466-3951
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Provider Business Mailing Address
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Address Line | 230 MIDDLE NECK RD STE 1
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City | GREAT NECK
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State | NY
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Zip | 11021-1113
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Country | US
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Telephone | 516-466-2585
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Fax | 516-466-3951
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. ALBERT YOUSSEFI
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Credential | DC
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Telephone | 516-466-2585
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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 | X007664-1
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License Number State | NY
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