Organization Name: | DP PT & CHIROPRACTIC, PLLC |
NPI Number: | 1508251612 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JACK J TESORIERO (MANAGING MEMBER) |
Mailing Address: | 2103 Deer Park Ave Deer Park |
State: | NY US |
Postal Code: | 117291319 |
Phone Number: | 6312424500 |
Fax Number: | 6312420885 |
NPI Enumeration Date: | 04/06/2015 |
NPI Last Update Date: | 01/22/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 004766 |
Healthcare Provider Taxonomy: (Secondary) | N |
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. |