J N Brodbeck DC PLLC
Organization Active NPI Clinic/Center · Wading River, NY
NPI 1649514969 · NPPES record last updated Jun 1, 2023
Key facts
- NPI
- 1649514969
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- License
- X4005-1 (NY)
- Legal business name
- J N BRODBECK DC PLLC
- Practice address
- 5976 Route 25a
Wading River, NY 11792-2001 - Phone
- (631) 345-3035
- Fax
- (631) 345-3244
- NPI assigned
- Nov 27, 2012
- Organization subpart
- No
Authorized official
- Name
- Jon N Brodbeck, D.C.
- Title
- Chiropractor
- Phone
- (631) 345-3035
Corporate family (same tax ID) 1
Practitioners 2
-
Jon Neil Brodbeck, D.C.
-
Terry Pontino, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050202000861 | NY | Part B Supplier - Clinic/Group Practice | 2567413941 |
Receives reassigned benefits from 2 practitioners Practice locations: Middle Island, NY |
National Provider Directory
- Tax ID family
- Brodbeck Chiropractic
Locations
169 Middle Country Rd
Middle Island, NY 11953
Phone (631) 345-3035
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | X4005-1 | NY | Yes |
Addresses
Primary practice location
5976 Route 25a
Wading River, NY 11792-2001
Mailing address
5976 Route 25a
Wading River, NY 11792-2001
Phone (631) 345-3035
Other names
- Brodbeck Chiropractic
Other providers in Wading River, NY
- Michelle Marie Iannone
- Alissa Iervese
- Island Comprehensive Care Inc.
- Island Foot and Ankle
- Island Rheumatology and Osteoporosis, PC
- J on N Eil Brodbeck DC PLLC
- Neil D Jaglall
- Alina Jakimiuk-Molik
- William Jantzen
- Art P Jarit
All providers in Wading River, NY · Clinic/Center in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 1, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.