MEDICARE: MIDTOWN TOTAL CHIROPRACTIC REHABILITATION, PLLC

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	111NR0400X	Rehabilitation Chiropractor	X010883-1	NY

General Provider Information

NPI Number	:	1417182320
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDTOWN TOTAL CHIROPRACTIC REHABILITATION, PLLC

Provider Business Mailing Address
First Line	:	235 E 49TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-1537
Country	:	US
Telephone Number	:	212-688-2900
Fax Number	:	212-759-8046

Provider Business Practice Location Address
First Line	:	235 E 49TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-1537
Country	:	US
Telephone Number	:	212-688-2900
Fax Number	:	212-759-8046

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DR. NOAM SADOVNIK
Credential	:	DC
Telephone Number	:	212-688-2900

Provider Enumeration Date	:	05/20/2009
Last Update Date	:	05/20/2009

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