MEDICARE: ELAN MICHAEL DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	013020	NY

General Provider Information

NPI Number	:	1316457955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELAN MICHAEL DC

Provider Business Mailing Address
First Line	:	465 COLUMBUS AVE STE 250
Second Line	:
City	:	VALHALLA
State	:	NY
Zip	:	10595-1376
Country	:	US
Telephone Number	:	914-292-5510
Fax Number	:

Provider Business Practice Location Address
First Line	:	465 COLUMBUS AVE STE 250
Second Line	:
City	:	VALHALLA
State	:	NY
Zip	:	10595-1376
Country	:	US
Telephone Number	:	914-292-5510
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2017
Last Update Date	:	02/09/2023

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Directions to “ ELAN MICHAEL DC” Practice Location

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