Provider Demographics
NPI:1487890927
Name:ALAN SIEGEL & JULIE SYAT PTR
Entity type:Organization
Organization Name:ALAN SIEGEL & JULIE SYAT PTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:SIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-352-0223
Mailing Address - Street 1:21418 41ST AVE
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-2103
Mailing Address - Country:US
Mailing Address - Phone:718-352-0223
Mailing Address - Fax:718-352-6287
Practice Address - Street 1:21418 41ST AVE
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2103
Practice Address - Country:US
Practice Address - Phone:718-352-0223
Practice Address - Fax:718-352-6287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02379Medicare PIN