NPIMap

Organization Active NPI

East New York Chiropractic,PC

  • Chiropractor
  • Flushing, NY
National Provider Identifier
1013427418
Registry record updated Oct 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X-011451-1 Issued in NY
Legal business name
EAST NEW YORK CHIROPRACTIC,PC
Practice address
4161 Kissena Blvd
Level C. Suite 35
Flushing, NY 11355
Phone
(718) 888-0300
NPI assigned
Oct 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2017

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

Authorized official

Name
Dr. Jae Ku Kim, DC
Title
President
Phone
(917) 373-0574

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X X-011451-1 NY Primary

Addresses

Primary practice location

4161 Kissena Blvd
Level C. Suite 35
Flushing, NY 11355

Mailing address

4161 Kissena Blvd
Level C. Suite 35
Flushing, NY 11355
Phone (718) 888-0300

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507680000000",
    "number": "1013427418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4161 KISSENA BLVD",
            "address_2": "LEVEL C. SUITE 35",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355",
            "telephone_number": "718-888-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4161 KISSENA BLVD",
            "address_2": "LEVEL C. SUITE 35",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355",
            "telephone_number": "718-888-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST NEW YORK CHIROPRACTIC,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-11",
        "last_updated": "2017-10-11",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JAE KU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-373-0574",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X-011451-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2017; 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.