Chirosport and Spine, LLC
Organization Active NPI Chiropractor · Endicott, NY
NPI 1003239922 · NPPES record last updated Apr 29, 2014
Key facts
- NPI
- 1003239922
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- X012250-1 (NY)
- Legal business name
- CHIROSPORT AND SPINE, LLC
- Practice address
- 421 E. Main St.
Endicott, NY 13760 - Phone
- (607) 321-7674
- Fax
- (855) 890-7728
- NPI assigned
- Jan 29, 2014
- Organization subpart
- No
Authorized official
- Name
- Dr. Brian L. Baldia, D.C.
- Title
- Owner/Chiropractor
- Phone
- (267) 253-7808
Practitioners 1
-
Brian Levy Baldia, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150317002626 | NY | Part B Supplier - Clinic/Group Practice | 6204153927 |
Receives reassigned benefits from 1 practitioner Practice locations: Endicott, NY |
National Provider Directory
Locations
421 E Main St
Endicott, NY 13760
Phone (607) 321-7674
2548 Vestal Pkwy E
Vestal, NY 13850
Phone (607) 321-7674
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | X012250-1 | NY | Yes |
| Chiropractor |
111N00000X | DC007952L | PA |
Addresses
Primary practice location
421 E. Main St.
Endicott, NY 13760
Mailing address
3103 Chatham Rd.
Endwell, NY 13760
Phone (607) 321-7674
Other providers in Endicott, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.