Organization Name: | REGO PARK CHIROPRACTIC PC |
NPI Number: | 1013063528 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DIANE M RENZULLI (PRES) |
Mailing Address: | 6298 Woodhaven Blvd Rego Park |
State: | NY US |
Postal Code: | 113743738 |
Phone Number: | 7188032300 |
Fax Number: | 7185652875 |
NPI Enumeration Date: | 01/26/2007 |
NPI Last Update Date: | 11/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | X004316-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |