Central Suffolk Spine & Sports Chiropractic

Chiropractor in Brentwood, NY. Organization (NPI-2).

NPI number1790449643

StatusActive

Last updated in NPPESOct 27, 2021

Details

NPI: 1790449643
Entity type: Organization (NPI-2)
Legal business name: Central Suffolk Spine & Sports Chiropractic
Organization subpart: No
Enumeration date: Oct 27, 2021
Certification date: Oct 27, 2021
Last updated: Oct 27, 2021

Medicare and OIG

Medicare enrolled (PECOS): Not in the Medicare enrollment file
Can order and refer: Not on the CMS order and referring list
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
111N00000X	Chiropractor	–	–	Yes

Practice location

55 Second Avenue
Suite 1
Brentwood, NY 11717

Phone 631-617-5733 · Fax 631-617-5731

Mailing address

55 Second Avenue
Suite 1
Brentwood, NY 11717

Phone 631-617-5733 · Fax 631-617-5731

Authorized official

Matthew Joseph Viso
Partner
6316175733

Is something wrong?

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Other Chiropractor providers in Brentwood, NY

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