Island Life Chiropractic Pain Care PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X009495 Issued in NY

Legal business name

ISLAND LIFE CHIROPRACTIC PAIN CARE PLLC

Practice address

2100 Deer Park Ave
Suite 8
Deer Park, NY 11729-2119

Phone

(631) 940-8739

Fax

(631) 940-8740

NPI assigned

Sep 23, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Darren Thomas Mollo, DC

Title

Owner

Phone

(631) 940-8739

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285200000000",
    "number": "1538477641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 DEER PARK AVE",
            "address_2": "SUITE 8",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117292119",
            "telephone_number": "631-940-8739",
            "fax_number": "631-940-8740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 DEER PARK AVE",
            "address_2": "SUITE 8",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117292119",
            "telephone_number": "631-940-8739",
            "fax_number": "631-940-8740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND LIFE CHIROPRACTIC PAIN CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-23",
        "last_updated": "2010-09-23",
        "status": "A",
        "authorized_official_last_name": "MOLLO",
        "authorized_official_first_name": "DARREN",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-940-8739",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X009495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Island Therapies of Suffolk, LLP
• Ulysses Jackson
• Christy Janes, PHYSICIAN ASSISTANT

• Chiropractor in Deer Park, NY
• Providers in Deer Park, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.