Provider Demographics
NPI:1427264514
Name:ROBERT L. BROSTOWIN DC PC
Entity type:Organization
Organization Name:ROBERT L. BROSTOWIN DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROSTOWIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC PC
Authorized Official - Phone:718-261-6705
Mailing Address - Street 1:7150 AUSTIN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4731
Mailing Address - Country:US
Mailing Address - Phone:718-261-6705
Mailing Address - Fax:718-261-6707
Practice Address - Street 1:7150 AUSTIN ST STE 102
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4731
Practice Address - Country:US
Practice Address - Phone:718-261-6705
Practice Address - Fax:718-261-6707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006335-1111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5G21OtherEMPIRE BC BS
NYC006335-6OtherWORKER COMP.
NY3031202OtherAETNA
NY5898013OtherGHI
NY4165432OtherCIGNA
NYP2679219OtherOXFORD
NY5G21OtherEMPIRE BC BS
NY=========OtherHIP
NY3031202OtherAETNA
NY=========OtherAARAP
NY4165432OtherCIGNA
NY=========OtherPRISM HEALTH NETWORKS
NYC006335-6OtherWORKER COMP.
NY=========OtherPROGRESSIVE GROUP INS. CO
NY=========OtherUNITED HEALTHCARE
NY=========OtherHIP
NY=========OtherAARAP