Imagine Chiropractic Healthcare, PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

010407 Issued in NY

Legal business name

IMAGINE CHIROPRACTIC HEALTHCARE, PLLC

Doing business as

Champion Performance and Rehabilitation

Practice address

5 S Jersey Ave
East Setauket, NY 11733-2045

Phone

(631) 675-2758

Fax

(631) 675-2760

NPI assigned

Nov 29, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. James Gucciardi, D.C.

Title

Owner

Phone

(631) 675-2758

Specialties & licenses 1

Addresses

Other names 1

• Champion Performance and Rehabilitation Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1290988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712102400000",
    "number": "1003118969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 202",
            "city": "SAINT JAMES",
            "state": "NY",
            "postal_code": "117800202",
            "telephone_number": "631-675-2758",
            "fax_number": "631-675-2760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 S JERSEY AVE",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117332045",
            "telephone_number": "631-675-2758",
            "fax_number": "631-675-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGINE CHIROPRACTIC HEALTHCARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-29",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A",
        "authorized_official_last_name": "GUCCIARDI",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-675-2758",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "010407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Champion Performance and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zeenat A Hussain, MD
• Irene Hwu, MD
• Judith Ann Hyrka, SPECIALIST
• Svetlana Ilizarov, M.D.
• Altan Kadri Ilkay, MD
• Diana Camille Indrigo, M.S.
• Ryan Scott Innes, PA-C
• Maria Iovino
• Suzanne Isaksen, PT
• Alaa A Ishak, PHARM.D.

• Chiropractor in East Setauket, NY
• Providers in East Setauket, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.