Provider Demographics
NPI:1699931022
Name:ADVANCED CARE CHIROPRACTIC OF N.Y., P.C
Entity type:Organization
Organization Name:ADVANCED CARE CHIROPRACTIC OF N.Y., P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:212-459-0400
Mailing Address - Street 1:315 W 55TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-4503
Mailing Address - Country:US
Mailing Address - Phone:212-459-0400
Mailing Address - Fax:212-247-8255
Practice Address - Street 1:315 W 55TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-4503
Practice Address - Country:US
Practice Address - Phone:212-459-0400
Practice Address - Fax:212-247-8255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty