MEDICARE: DR. GEORGE TAISHIN 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	111NI0013X	Independent Medical Examiner Chiropractor	013638	NY
2	111NS0005X	Sports Physician Chiropractor	013638	NY
3	111NR0400X	Rehabilitation Chiropractor	013638	NY
4	111NX0100X	Occupational Health Chiropractor	013638	NY
5	111NN1001X	Nutrition Chiropractor	013638	NY
6	111N00000X	Chiropractor	013638	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	013638	OTHER	NY	NEW YORK STATE CHIROPRACTIC LICENSE

General Provider Information

NPI Number	:	1336877273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE TAISHIN DC

Provider Business Mailing Address
First Line	:	173 JACQUES AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-3029
Country	:	US
Telephone Number	:	718-909-9070
Fax Number	:

Provider Business Practice Location Address
First Line	:	1103 FRANKLIN AVE APT 4
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10456-6721
Country	:	US
Telephone Number	:	718-909-9070
Fax Number	:

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

Provider Enumeration Date	:	08/09/2022
Last Update Date	:	02/05/2026

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Directions to “ DR. GEORGE TAISHIN DC” Practice Location

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