New York Core Chiropractic P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X012540-1 Issued in NY

Legal business name

NEW YORK CORE CHIROPRACTIC P.C.

Practice address

20935 Northern Blvd Ste 209a
Bayside, NY 11361-3134

Phone

(718) 577-8933

NPI assigned

Aug 24, 2016

Organization subpart

No

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

Authorized official

Name

Ivan Lam, D.C.NPI 1366859761

Title

Owner

Phone

(718) 577-8933

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

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

• Ivan Lam, DC

  • Chiropractor
  • Bayside, NY
  • NPI 1366859761
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592179200000",
    "number": "1508311135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20810 CROSS ISLAND PKWY # 528",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113601187",
            "telephone_number": "718-577-8933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20935 NORTHERN BLVD STE 209A",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613134",
            "telephone_number": "718-577-8933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK CORE CHIROPRACTIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-24",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A",
        "authorized_official_last_name": "LAM",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-577-8933",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X012540-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Bayside, NY
• Providers in Bayside, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.