New York Injury Chiropractic Rehab PC

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

Legal business name

NEW YORK INJURY CHIROPRACTIC REHAB PC

Practice address

3723 72ND St FL 1
Jackson Heights, NY 11372-6126

Phone

(718) 255-1533

NPI assigned

Jul 27, 2023

Organization subpart

No

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

Authorized official

Name

Avianne Waithe, DCNPI 1518366376

Title

Chiropractic Doctor/Ao

Phone

(443) 622-9429

Specialties & licenses 5

Addresses

Tax ID family

New York Injury Chiropractic Rehab PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• New York Injury Chiropractic Rehab PC

  • Rehabilitation Chiropractor
  • Montclair, NJ
  • NPI 1063085181
  NPD tax ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Avianne Waithe, D.C.

  • Chiropractor
  • Jackson Heights, NY
  • NPI 1518366376

  Rehabilitation

  NPD Authorized official
• Andrew Paek, L.AC

  • Acupuncturist
  • Maspeth, NY
  • NPI 1114753571
  NPD (past)

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

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694736000000",
    "number": "1295416618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3723 72ND ST FL 1",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113726126",
            "telephone_number": "443-622-9429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3723 72ND ST FL 1",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113726126",
            "telephone_number": "718-255-1533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK INJURY CHIROPRACTIC REHAB PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-27",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A",
        "authorized_official_last_name": "WAITHE",
        "authorized_official_first_name": "AVIANNE",
        "authorized_official_title_or_position": "CHIROPRACTIC DOCTOR/AO",
        "authorized_official_telephone_number": "443-622-9429",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246ZE0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "247200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Chiropractor in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Rehabilitation Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.