1396984084 NPI number — CHIROPRACTIC HEALING ARTS, P.C.

Table of content: CYNTHIA MARIE OBERDIER LMT (NPI 1598211096)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396984084 NPI number — CHIROPRACTIC HEALING ARTS, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHIROPRACTIC HEALING ARTS, 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:
6
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:
1396984084
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/01/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3 HENRY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGTON
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11743-5635
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-445-4302
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
326 WALT WHITMAN RD STE 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGTON STATION
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11746-8700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-885-8085
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/19/2009

Additional Information

Authorized Official

Authorized Official Last Name:
DECHIARA
Authorized Official First Name:
VANESSA
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIROPRACTOR/PRESIDENT
Authorized Official Telephone Number:
516-445-4302

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  009416 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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