East Park Chiropractic Wellness PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

EAST PARK CHIROPRACTIC WELLNESS PC

Practice address

714 E Park Ave
Long Beach, NY 11561-2605

Phone

(516) 431-7972

NPI assigned

May 20, 2021

Last updated

May 20, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles Drake, DCNPI 1568086387

Title

President

Phone

(516) 323-9145

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

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.

• Charles Drake, DC

  • Chiropractor
  • Long Beach, NY
  • NPI 1568086387
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621468800000",
    "number": "1700451093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 E PARK AVE",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115612605",
            "telephone_number": "516-323-9145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 E PARK AVE",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115612605",
            "telephone_number": "516-431-7972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST PARK CHIROPRACTIC WELLNESS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A",
        "authorized_official_last_name": "DRAKE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-323-9145",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Dyba
• Early Interverntion
• East Park Chiropractic
• East Park Chiropractic
• East Park Chiropractic and NP in Acute Care PLLC
• Natalie Ebitz
• Lisa Eblen
• Jaclyn Eiger, CCC-SLP
• Amy L Eisenberg
• Jo Eisman, D.C.

• 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 May 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.