Provider Demographics
NPI:1386708543
Name:GREATER HEALTH THROUGH CHIROPRACTIC PC
Entity type:Organization
Organization Name:GREATER HEALTH THROUGH CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ABY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHADI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-441-4070
Mailing Address - Street 1:38 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1014
Mailing Address - Country:US
Mailing Address - Phone:718-441-4070
Mailing Address - Fax:718-441-4027
Practice Address - Street 1:9525 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11421-2268
Practice Address - Country:US
Practice Address - Phone:718-441-4070
Practice Address - Fax:718-441-4027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009682261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV06117Medicare UPIN