NPIMap

Organization Active NPI

Walter E. Mendoza Chiropractor, P.C

  • Sports Physician Chiropractor
  • Freeport, NY
National Provider Identifier
1629198908
Registry record updated Jul 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
010611 Issued in NY
Legal business name
WALTER E. MENDOZA CHIROPRACTOR, P.C
Practice address
330 S Long Beach Ave
Freeport, NY 11520-4345
Phone
(516) 213-4610
Fax
(516) 213-4819
NPI assigned
Mar 30, 2007
Last updated
Jul 23, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2007

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

Authorized official

Name
Dr. Walter Enrique Mendoza, D.C.NPI 1780703538
Title
Chiropractor
Phone
(516) 213-4610

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 010611 NY Primary

Addresses

Primary practice location

330 S Long Beach Ave
Freeport, NY 11520-4345

Mailing address

330 S Long Beach Ave
Freeport, NY 11520-4345
Phone (516) 213-4610

National Provider Directory

National Provider Directory

Locations

357 Broadway
Ste 2A
Amityville, NY 11701
Phone (631) 532-6663

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185148800000",
    "number": "1629198908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 S LONG BEACH AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115204345",
            "telephone_number": "516-213-4610",
            "fax_number": "516-213-4819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 S LONG BEACH AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115204345",
            "telephone_number": "516-213-4610",
            "fax_number": "516-213-4819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER E. MENDOZA CHIROPRACTOR, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-23",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "ENRIQUE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "516-213-4610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NY",
            "license": "010611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; 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.