Organization · NPI-2

Bayshore Chiropractic PC

Chiropractor · Bay Shore, NY

NPI number1255646360
StatusActive
Last updated in NPPESAug 12, 2010

Details

NPI
1255646360
Entity type
Organization (NPI-2)
Legal business name
Bayshore Chiropractic PC
Organization subpart
No
Enumeration date
Aug 12, 2010
Last updated
Aug 12, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111N00000X ChiropractorX009043NYYes

Practice location

1590 Union Blvd
Bay Shore, NY 11706-7358

Phone 631-665-2421

Mailing address

595 Stewart Ave
Suite 750
Garden City, NY 11530-4787

Phone 516-307-1345

Authorized official

Robert Super
President
5163071345

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