MEDICARE: ADVANCED CARE CHIROPRACTIC OF N.Y., 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	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1699931022
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED CARE CHIROPRACTIC OF N.Y., P.C

Provider Business Mailing Address
First Line	:	315 W 55TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10019-4503
Country	:	US
Telephone Number	:	212-459-0400
Fax Number	:	212-247-8255

Provider Business Practice Location Address
First Line	:	315 W 55TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10019-4503
Country	:	US
Telephone Number	:	212-459-0400
Fax Number	:	212-247-8255

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LAUREN FRIES
Credential	:	D.C.
Telephone Number	:	212-459-0400

Provider Enumeration Date	:	08/05/2008
Last Update Date	:	08/05/2008

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