MEDICARE: ELAN MICHAEL CHIROPRACTIC, P.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	225700000X	Massage Therapist
2	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1659078269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELAN MICHAEL CHIROPRACTIC, P.C.

Provider Business Mailing Address
First Line	:	465 COLUMBUS AVE STE 250
Second Line	:
City	:	VALHALLA
State	:	NY
Zip	:	10595-1376
Country	:	US
Telephone Number	:	516-343-3203
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	:	516-343-3203
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ELAN N MICHAEL
Credential	:	DC
Telephone Number	:	516-343-3203

Provider Enumeration Date	:	02/14/2023
Last Update Date	:	03/01/2023

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