Ny Chiropractic Rehabilitation PC

Primary specialty

Independent Medical Examiner ChiropractorTaxonomy code 111NI0013X

Legal business name

NY CHIROPRACTIC REHABILITATION PC

Practice address

2995 Ocean Pkwy
Brooklyn, NY 11235-8390

Phone

(718) 714-0090

Fax

(718) 714-0092

NPI assigned

Jun 25, 2015

Organization subpart

No

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

Authorized official

Name

Diana Vavikova, DC

Title

President

Phone

(718) 714-0090

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435190400000",
    "number": "1033591052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 OCEAN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358390",
            "telephone_number": "718-714-0090",
            "fax_number": "718-714-0092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2995 OCEAN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358390",
            "telephone_number": "718-714-0090",
            "fax_number": "718-714-0092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NY CHIROPRACTIC REHABILITATION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-25",
        "last_updated": "2015-06-25",
        "status": "A",
        "authorized_official_last_name": "VAVIKOVA",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-714-0090",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NI0013X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Independent Medical Examiner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; 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.