Provider Demographics
NPI:1588759666
Name:DOORNICK, JEAN-CLAUDE (DC)
Entity type:Individual
Prefix:DR
First Name:JEAN-CLAUDE
Middle Name:
Last Name:DOORNICK
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 1:550 MAMARONECK AVE
Mailing Address - Street 2:SUITE NUMBER 103
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-1634
Mailing Address - Country:US
Mailing Address - Phone:914-346-5200
Mailing Address - Fax:914-346-5201
Practice Address - Street 1:550 MAMARONECK AVE
Practice Address - Street 2:SUITE NUMBER 103
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-1634
Practice Address - Country:US
Practice Address - Phone:914-346-5200
Practice Address - Fax:914-346-5201
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043656887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX4V243OtherBLUE CROSS BLUE SHIELD
NYX4V243OtherBLUE CROSS BLUE SHIELD