Island South Chiropractic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X010715NY Issued in NY

Legal business name

ISLAND SOUTH CHIROPRACTIC PC

Practice address

91 Foster Rd
Staten Island, NY 10309

Phone

(718) 966-7000

Fax

(718) 317-7452

NPI assigned

Mar 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Justin L Bergin, DCNPI 1871622431

Title

Owner

Phone

(718) 966-7000

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 2

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

• Justin L Bergin, DC

  • Chiropractor
  • Manalapan, NJ
  • NPI 1871622431
  NPD (past) Authorized official
• Michael Andrew Minardo, D.C.

  • Sports Physician Chiropractor
  • New York, NY
  • NPI 1124126818
  NPD (past)

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639208200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 FOSTER RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10309",
            "telephone_number": "718-966-7000",
            "fax_number": "718-317-7452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 FOSTER RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10309",
            "telephone_number": "718-966-7000",
            "fax_number": "718-317-7452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND SOUTH CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERGIN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-966-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X010715NY",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7929464",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2952873",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2952873",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Island Rehab PT OT PLLC
• Island Rehabilitative Services Corp
• Island Rehabilitative Services Corp.
• Island Reproductive Services, PC
• Island Sleep Solutions
• Island Wide Respiratory, Inc.
• Ismaeel Pharmacy Inc (Brighton Community Pharmacy)
• Wuraola Ismaila
• Valbona Ismailanji, AGPCNP-BC
• Melissa Israel, D.D.S.

• Chiropractor in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.