Active NPI
Teresa Marie Wukich, D.C.
- Chiropractor
- East Northport, NY
National Provider Identifier
1033296488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X006736-1
- Practice address
- 483 Elwood Rd
East Northport, NY 11731-4804 - Phone
- (631) 266-1558
- Fax
- (631) 368-0340
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X006736-1 | NY | Primary |
Addresses
Primary practice location
483 Elwood Rd
East Northport, NY 11731-4804
Mailing address
483 Elwood Rd
East Northport, NY 11731-4804
Phone (631) 368-0340
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CO-6736-5 | Other | NY | WORKER'S COMPENSATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X006736-1 | NY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033296488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "483 ELWOOD RD",
"city": "EAST NORTHPORT",
"state": "NY",
"postal_code": "117314804",
"telephone_number": "631-368-0340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "483 ELWOOD RD",
"city": "EAST NORTHPORT",
"state": "NY",
"postal_code": "117314804",
"telephone_number": "631-266-1558",
"fax_number": "631-368-0340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WUKICH",
"first_name": "TERESA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X006736-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKER'S COMPENSATION",
"identifier": "CO-6736-5",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Northport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.