Provider Demographics
NPI:1306057344
Name:HUMBLE, JOSEPH LEON II (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:LEON
Last Name:HUMBLE
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1723 E 12TH ST
Mailing Address - Street 2:BROOKLYN
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1069
Mailing Address - Country:US
Mailing Address - Phone:347-524-6554
Mailing Address - Fax:718-336-1518
Practice Address - Street 1:1723 E 12TH ST
Practice Address - Street 2:SUITE #5L
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1069
Practice Address - Country:US
Practice Address - Phone:347-524-6554
Practice Address - Fax:718-336-1518
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYX009933111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX03V3BW271Medicare ID - Type Unspecified