Deer Park Chiropractic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

DEER PARK CHIROPRACTIC PC

Practice address

2103 Deer Park Ave Ste 1
Deer Park, NY 11729-1317

Phone

(631) 242-4500

NPI assigned

Apr 12, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Jack J Tesoriero

Title

President

Phone

(631) 680-2166

Specialties & licenses 1

Addresses

Other names 1

• PTDC Chiropractic Doing business as

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

{
    "created_epoch": "1712880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1194579664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 DEER PARK AVE STE 1",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117291317",
            "telephone_number": "631-242-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 DEER PARK AVE STE 1",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117291317",
            "telephone_number": "631-242-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEER PARK CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-12",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "TESORIERO",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-680-2166",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PTDC Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Marie Davis, LMSW
• Princess Davis
• Siah Davis
• Pamela J Day, LCSW
• Deer Park Chiropractic and Physical Therapy PLLC
• Deer Park Fire District 14 Inc
• Deer Park Medical, P.C.
• Deer Park Medical, P.C.
• Deer Park Physical Therapy & Chiropractic
• Deer Park Physical Therapy and Chiropractic PLLC

• Chiropractor in Deer Park, NY
• Providers in Deer Park, 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 12, 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.