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General NPI Number Information
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NPI Number | 1962878454
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Entity Type | Organization
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Legal Business Name | SUFFOLK CHIROPRACTIC REHABILITATION, P.C.
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Dates
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Enumeration Date | 08/19/2015
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Last Update Date | 08/19/2015
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Provider Practice Location Address
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Address Line | 439 WILLIAM FLOYD PKWY SUITE E
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City | SHIRLEY
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State | NY
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Zip | 11967-3466
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Country | US
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Telephone | 631-772-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 439 SUITE E WILLIAM FLOYD PARKWAY
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City | SHIRLEY
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State | NY
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Zip | 11967-0000
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Country | US
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Telephone | 631-772-7000
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. GARY M STEIN
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Credential | D.C.
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Telephone | 631-772-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | X3391
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License Number State | NY
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