J on N Eil Brodbeck DC PLLC

Primary specialty

Nutrition ChiropractorTaxonomy code 111NN1001X

License

X4005 Issued in NY

Legal business name

J ON N EIL BRODBECK DC PLLC

Practice address

5976 Route 25a
Wading River, NY 11792-2001

Phone

(631) 345-3035

Fax

(631) 345-3244

NPI assigned

Aug 27, 2008

Organization subpart

No

Name

Dr. Jon Neil Brodbeck, D.C.NPI 1477612547

Title

Chiropractor

Phone

(631) 345-3035

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

• Jon Neil Brodbeck, D.C.

  • Chiropractor
  • Wading River, NY
  • NPI 1477612547
  NPD Authorized official

Tax ID family

Brodbeck Chiropractic2 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.

• J N Brodbeck DC PLLC

  • Clinic/Center
  • Wading River, NY
  • NPI 1649514969
  NPD tax ID

Locations

• Brodbeck Chiropractic & Wellness Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 1, 2023.

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1356598734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5976 ROUTE 25A",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117922001",
            "telephone_number": "631-345-3035",
            "fax_number": "631-345-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5976 ROUTE 25A",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117922001",
            "telephone_number": "631-345-3035",
            "fax_number": "631-345-3244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J ON N EIL BRODBECK DC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-27",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "BRODBECK",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "NEIL",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "631-345-3035",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "NY",
            "license": "X4005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brodbeck Chiropractic & Wellness",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Brodbeck Chiropractic & Wellness",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Alissa Iervese
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• Island Rheumatology and Osteoporosis, PC
• J N Brodbeck DC PLLC
• Neil D Jaglall, M.D.
• Alina Jakimiuk-Molik, RN
• William Jantzen, PT
• Art P Jarit, D.D.S.
• Sisley John, RPH

• All providers in Wading River, NY
• Nutrition Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.