1154530921 NPI number — HEALTHWORLD CHIROPRACTIC GROUP P C

Table of content: (NPI 1154530921)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154530921 NPI number — HEALTHWORLD CHIROPRACTIC GROUP P C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTHWORLD CHIROPRACTIC GROUP P C
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154530921
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/07/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
234 N CENTRAL AVE
Provider Second Line Business Mailing Address:
ROOM 204
Provider Business Mailing Address City Name:
HARTSDALE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10530-1809
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-683-1777
Provider Business Mailing Address Fax Number:
914-683-8951

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
234 N CENTRAL AVE
Provider Second Line Business Practice Location Address:
ROOM 204
Provider Business Practice Location Address City Name:
HARTSDALE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10530-1809
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-683-1777
Provider Business Practice Location Address Fax Number:
914-683-8951
Provider Enumeration Date:
05/21/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
YOUNG
Authorized Official First Name:
GARY
Authorized Official Middle Name:
BURTON
Authorized Official Title or Position:
OWNER PRESIDENT
Authorized Official Telephone Number:
914-683-1777

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  X003307-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 133N00000X , with the licence number: 003843-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)