MEDICARE: HC CHIROPRACTIC IMAGING PC

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	261QR0208X	Mobile Radiology Clinic/Center	X012523-1	NY

General Provider Information

NPI Number	:	1639529241
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HC CHIROPRACTIC IMAGING PC

Provider Business Mailing Address
First Line	:	5509 MERRICK RD
Second Line	:
City	:	MASSAPEQUA
State	:	NY
Zip	:	11758-6215
Country	:	US
Telephone Number	:	516-541-8933
Fax Number	:	516-549-5034

Provider Business Practice Location Address
First Line	:	5509 MERRICK RD
Second Line	:
City	:	MASSAPEQUA
State	:	NY
Zip	:	11758-6215
Country	:	US
Telephone Number	:	516-541-8933
Fax Number	:	516-549-5034

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	DR. JOHN MILONE
Credential	:	D.C.
Telephone Number	:	516-541-8933

Provider Enumeration Date	:	06/14/2016
Last Update Date	:	07/20/2016

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