Doctor Name: | DR. STEVEN MICHAEL GERVASIO |
NPI Number: | 1447487913 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DC |
License Number: | X011710-1 |
Business Practice Address: | 5500 Merrick Rd Massapequa, NY - 117586231 |
Business Phone Number: | 5165418933 |
Business Fax Number: | 5165495034 |
Mailing Address: | 813 N Jefferson Ave, LINDENHURST |
State: | NY |
Postal Code: | 117572905 |
Phone Number: | 6312584061 |
Fax Number: | 5165495034 |
NPI Enumeration Date: | 06/11/2009 |
NPI Last Update Date: | 06/11/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | X011710-1 |
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. |