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NPI Code Detail

MEDICARE: ADVANCED CHIROPRACTIC OF LONG ISLAND, P.C.

MEDICARE: ADVANCED CHIROPRACTIC OF LONG ISLAND, 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
1111N00000XChiropractorX009618NY

General Provider Information

NPI Number : 1770786501
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED CHIROPRACTIC OF LONG ISLAND, P.C.
Provider Business Mailing Address
First Line : 1842 E JERICHO TPKE
Second Line :
City : HUNTINGTON
State : NY
Zip : 11743-5796
Country : US
Telephone Number : 631-421-4020
Fax Number : 631-421-4185
Provider Business Practice Location Address
First Line : 1842 E JERICHO TPKE
Second Line :
City : HUNTINGTON
State : NY
Zip : 11743-5796
Country : US
Telephone Number : 631-421-4020
Fax Number : 631-421-4185
Authorized Official
Title or Position : OWNER
Name : DR. KEITH SOLOMON
Credential : D.C.
Telephone Number : 631-421-4020
Provider Enumeration Date : 06/08/2007
Last Update Date : 07/19/2011

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Directions to “ADVANCED CHIROPRACTIC OF LONG ISLAND, P.C. ” Practice Location

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