Provider Demographics
NPI:1841726288
Name:ARCHER LEWIS CHIROPRACTIC PC
Entity type:Organization
Organization Name:ARCHER LEWIS CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARCHER
Authorized Official - Middle Name:
Authorized Official - Last Name:IRBY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-759-3088
Mailing Address - Street 1:770 RIVER RD
Mailing Address - Street 2:#26
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-6602
Mailing Address - Country:US
Mailing Address - Phone:201-759-3088
Mailing Address - Fax:800-348-5167
Practice Address - Street 1:1336 UTICA AVE
Practice Address - Street 2:2ND FLR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-5912
Practice Address - Country:US
Practice Address - Phone:201-759-3088
Practice Address - Fax:800-348-5167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-04
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010162111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty