Provider Demographics
NPI:1316122872
Name:DONALD H. MACREADY DC PC
Entity type:Organization
Organization Name:DONALD H. MACREADY DC PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:H
Authorized Official - Last Name:MACREADY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-745-7560
Mailing Address - Street 1:446 BAY RIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209
Mailing Address - Country:US
Mailing Address - Phone:718-745-7560
Mailing Address - Fax:
Practice Address - Street 1:446 BAY RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209
Practice Address - Country:US
Practice Address - Phone:718-745-7560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007131-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY915-184OtherMULTIPLAN
NYP2189331OtherOXFORD
NY1C8870OtherLANDMARK/HEALTHNET
NY445-6923OtherAETNA USHC
NYP-57139150OtherMULTIPLAN UNIQUE PROVIDER
NY5802456OtherGHI
NYC007131-8OtherWORKERS COMPENSATION
NYP-57139150OtherMULTIPLAN UNIQUE PROVIDER