Provider Demographics
NPI:1386901452
Name:RIU CHIROPRACTIC PC
Entity type:Organization
Organization Name:RIU CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROMAN
Authorized Official - Middle Name:V
Authorized Official - Last Name:VAYNSHTEYN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-769-8400
Mailing Address - Street 1:1656 E 21ST ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-5070
Mailing Address - Country:US
Mailing Address - Phone:718-769-8400
Mailing Address - Fax:
Practice Address - Street 1:2753 CONEY ISLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5015
Practice Address - Country:US
Practice Address - Phone:718-769-8400
Practice Address - Fax:718-769-3255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-13
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty