Provider Demographics
NPI:1427153972
Name:TRI STATE CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:TRI STATE CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:D
Authorized Official - Last Name:ALBIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-231-1877
Mailing Address - Street 1:665 PELHAM PKWY N
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-8068
Mailing Address - Country:US
Mailing Address - Phone:718-231-1877
Mailing Address - Fax:718-231-1501
Practice Address - Street 1:665 PELHAM PKWY N
Practice Address - Street 2:SUITE 2C
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-8068
Practice Address - Country:US
Practice Address - Phone:718-231-1877
Practice Address - Fax:718-231-1501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008837261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center