MEDICARE: JW CHIROPRACTIC 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	111N00000X	Chiropractor	X010978	NY

General Provider Information

NPI Number	:	1720247307
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JW CHIROPRACTIC PLLC

Provider Business Mailing Address
First Line	:	115 W 45TH ST
Second Line	:	SUITE 301
City	:	NEW YORK
State	:	NY
Zip	:	10036-4005
Country	:	US
Telephone Number	:	212-922-9200
Fax Number	:	212-922-9553

Provider Business Practice Location Address
First Line	:	115 W 45TH ST
Second Line	:	SUITE 301
City	:	NEW YORK
State	:	NY
Zip	:	10036-4005
Country	:	US
Telephone Number	:	212-922-9200
Fax Number	:	212-922-9553

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. JAMES JUN WONG
Credential	:	D.C.
Telephone Number	:	212-922-9200

Provider Enumeration Date	:	06/09/2008
Last Update Date	:	11/09/2016

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