MEDICARE: IVY LEE D.C.

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	X010745	NY

General Provider Information

NPI Number	:	1609195023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IVY LEE D.C.

Provider Business Mailing Address
First Line	:	PO BOX 130403
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10013-0995
Country	:	US
Telephone Number	:	917-981-9581
Fax Number	:	212-219-0148

Provider Business Practice Location Address
First Line	:	191 CANAL ST
Second Line	:	ROOM 603
City	:	NEW YORK
State	:	NY
Zip	:	10013-4524
Country	:	US
Telephone Number	:	917-981-9581
Fax Number	:	212-219-0148

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

Provider Enumeration Date	:	05/25/2010
Last Update Date	:	05/25/2010

Similar Medicare Providers

1063557239 — DR. PAUL K SHENG D.C.
Practice Location Address:

191 CANAL ST , ROOM 603
NEW YORK, NY
10013-4524

Practice Phone: 212-274-1488
Practice Fax: 212-219-0148

1760671317 — DR. STANLEY NG M.D.
Practice Location Address:

191 CANAL ST , SUITE 601
NEW YORK, NY
10013-4524

Practice Phone: 212-925-3224
Practice Fax:

1093640955 — EDY SUPPLY INC
Practice Location Address:

1 W 125TH ST STE 236
NEW YORK, NY
10027-4524

Practice Phone: 917-209-3906
Practice Fax:

1609166578 — MS. CRYSTAL LYNN DIAZ OTR/L
Practice Location Address:

60 E 104TH ST , 3C
NEW YORK, NY
10029-4524

Practice Phone: 212-933-0820
Practice Fax:

1922362938 — DRSELENA
Practice Location Address:

27 NEW YORK CT
MONARCH BEACH, CA
92629-4524

Practice Phone: 949-528-5013
Practice Fax:

1619500063 — SALVATORE JOSEPH MILAZZO PA-C
Practice Location Address:

1 W 125TH ST FRNT 3
NEW YORK, NY
10027-4524

Practice Phone: 212-265-2500
Practice Fax: 646-952-0260

Directions to “ IVY LEE D.C.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.