Ny Disc Chiropractic, PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

NY DISC CHIROPRACTIC, PC

Practice address

15419 Northern Blvd # 2F-5
Flushing, NY 11354-5029

Phone

(718) 746-4919

Fax

(718) 746-4920

NPI assigned

Apr 18, 2022

Organization subpart

No

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

Authorized official

Name

Sangwoo Mah, DC

Title

Owner

Phone

(917) 626-3037

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650326400000",
    "number": "1245973270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15419 NORTHERN BLVD # 2F-5",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545029",
            "telephone_number": "718-746-4919",
            "fax_number": "718-746-4920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15419 NORTHERN BLVD # 2F-5",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545029",
            "telephone_number": "718-746-4919",
            "fax_number": "718-746-4920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NY DISC CHIROPRACTIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-18",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "MAH",
        "authorized_official_first_name": "SANGWOO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-626-3037",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS OFFICE OF PROFESSIONS",
            "identifier": "9835",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nydiscchiro@protonmail.com",
            "affiliation": "N",
            "endpointDescription": "office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "15419 Northern Blvd # 2F-5",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113545029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.