Provider Demographics
NPI:1316967409
Name:ALBIS, PETER D (DC)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:D
Last Name:ALBIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 CENTRAL PARK AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710
Mailing Address - Country:US
Mailing Address - Phone:914-337-6730
Mailing Address - Fax:914-337-5734
Practice Address - Street 1:1730 CENTRAL PARK AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-4905
Practice Address - Country:US
Practice Address - Phone:914-337-6730
Practice Address - Fax:914-337-5734
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008837111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX4R621Medicare ID - Type Unspecified