Plaza 1 Chiropractic P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X011451-1 Issued in NY

Legal business name

PLAZA 1 CHIROPRACTIC P.C.

Practice address

142-25 37TH Ave.
#C2
Flushing, NY 11354-6531

Phone

(718) 359-3777

Fax

(718) 359-3770

NPI assigned

Mar 29, 2010

Organization subpart

No

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

Authorized official

Name

Jae Ku Kim, D.C.

Title

President

Phone

(718) 359-3777

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269820800000",
    "number": "1376868869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142-25 37TH AVE.",
            "address_2": "#C2",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546531",
            "telephone_number": "718-359-3777",
            "fax_number": "718-359-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142-25 37TH AVE.",
            "address_2": "#C2",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546531",
            "telephone_number": "718-359-3777",
            "fax_number": "718-359-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAZA 1 CHIROPRACTIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-29",
        "last_updated": "2010-03-29",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JAE KU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-359-3777",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X011451-1",
            "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 Mar 29, 2010; 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.