Provider Demographics
NPI:1285763938
Name:AMIRAN, YORAM (DC, LAC)
Entity type:Individual
Prefix:DR
First Name:YORAM
Middle Name:
Last Name:AMIRAN
Suffix:
Gender:M
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 HOLLY CT
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-2312
Mailing Address - Country:US
Mailing Address - Phone:631-367-2229
Mailing Address - Fax:631-367-2229
Practice Address - Street 1:3 HOLLY CT
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-2312
Practice Address - Country:US
Practice Address - Phone:631-367-2229
Practice Address - Fax:631-367-2229
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008297-1111N00000X
NY002269-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC08297-6WOtherWORKERS COMPENSATION
NYP1033193OtherOXFORD
NYX89342Medicare ID - Type UnspecifiedDC