MEDICARE: DR. TERRY HOPE EAGLE DC

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	X002424	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CE1459	OTHER	NY	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1972542728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERRY HOPE EAGLE DC

Provider Business Mailing Address
First Line	:	3 DELAWARE DR
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11042-1116
Country	:	US
Telephone Number	:	516-608-2880
Fax Number	:	516-608-6887

Provider Business Practice Location Address
First Line	:	3 DELAWARE DR
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11042-1116
Country	:	US
Telephone Number	:	516-608-2880
Fax Number	:	516-608-6887

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	02/06/2013

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Directions to “ DR. TERRY HOPE EAGLE DC” Practice Location

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