Genesis Chiropractic Pain Management P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X011936 Issued in NY

Legal business name

GENESIS CHIROPRACTIC PAIN MANAGEMENT P.C.

Practice address

164 East Penn Street
Long Beach, NY 11561

Phone

(646) 581-2541

Fax

(718) 301-1804

NPI assigned

May 6, 2011

Reactivated

Dec 19, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Mazal Jennifer Suynov, D.C.

Title

Owner

Phone

(646) 581-2541

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1304640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355875200000",
    "number": "1629360805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 703",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115610703",
            "telephone_number": "646-581-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 EAST PENN STREET",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "11561",
            "telephone_number": "646-581-2541",
            "fax_number": "718-301-1804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS CHIROPRACTIC PAIN MANAGEMENT P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-06",
        "last_updated": "2012-12-19",
        "deactivation_date": "2012-09-20",
        "reactivation_date": "2012-12-19",
        "status": "A",
        "authorized_official_last_name": "SUYNOV",
        "authorized_official_first_name": "MAZAL",
        "authorized_official_middle_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "646-581-2541",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X011936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Long Beach, NY
• Providers in Long Beach, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; 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.