Provider Demographics
NPI:1487737607
Name:CHAMBERLAIN, CRAIG JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:JOSEPH
Last Name:CHAMBERLAIN
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 1:32 STATION DR
Mailing Address - Street 2:
Mailing Address - City:WYANDANCH
Mailing Address - State:NY
Mailing Address - Zip Code:11798-3436
Mailing Address - Country:US
Mailing Address - Phone:516-798-8363
Mailing Address - Fax:516-798-8586
Practice Address - Street 1:32 STATION DR
Practice Address - Street 2:
Practice Address - City:WYANDANCH
Practice Address - State:NY
Practice Address - Zip Code:11798-3436
Practice Address - Country:US
Practice Address - Phone:516-798-8363
Practice Address - Fax:516-798-8586
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX-007733111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU52463Medicare UPIN
NYX66341Medicare ID - Type Unspecified