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General NPI Number Information
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NPI Number | 1992983035
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Entity Type | Individual
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Provider Name | ANDREAS CLIRONOMOS DC
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Gender | Male
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Dates
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Enumeration Date | 01/31/2008
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Last Update Date | 12/26/2013
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Provider Practice Location Address
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Address Line | 2818 31ST ST
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City | ASTORIA
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State | NY
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Zip | 11102-1745
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Country | US
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Telephone | 646-239-0353
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Fax |
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Provider Business Mailing Address
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Address Line | 2540 31ST ST
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City | ASTORIA
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State | NY
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Zip | 11102-1749
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Country | US
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Telephone | 646-239-0353
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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 | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 011589
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License Number State | NY
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