=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962773903
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LINDER CHIROPRACTIC, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/23/2012
-----------------------------------------------------
Last Update Date | 06/15/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 325 MERRICK AVE STE 3
-----------------------------------------------------
City | EAST MEADOW
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11554-1556
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-926-0900
-----------------------------------------------------
Fax | 212-926-0902
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 325 MERRICK AVE STE 3
-----------------------------------------------------
City | EAST MEADOW
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11554-1556
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 122-926-0900
-----------------------------------------------------
Fax | 129-260-9022
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | JEFFREY KEVIN LINDER
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 516-926-0900
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | X008341
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------