Provider Demographics
NPI:1285783795
Name:TOUCH OF LIFE CHIROPRACTIC EAST PC
Entity type:Organization
Organization Name:TOUCH OF LIFE CHIROPRACTIC EAST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:MENIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:631-874-2797
Mailing Address - Street 1:581 MONTAUK HWY
Mailing Address - Street 2:
Mailing Address - City:EASTPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11941-1128
Mailing Address - Country:US
Mailing Address - Phone:631-874-2797
Mailing Address - Fax:631-874-9387
Practice Address - Street 1:581 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:EASTPORT
Practice Address - State:NY
Practice Address - Zip Code:11941-1128
Practice Address - Country:US
Practice Address - Phone:631-874-2797
Practice Address - Fax:631-874-9387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007341111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX70321Medicare ID - Type UnspecifiedINDIVIDUAL ID NUMBER
NYXFW531Medicare ID - Type UnspecifiedGROUP ID NUMBER