Oceanside Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X007427 Issued in NY

Legal business name

OCEANSIDE CHIROPRACTIC

Practice address

4280 Hylan Blvd
Staten Island, NY 10312-6526

Phone

(718) 948-7811

Fax

(718) 948-1018

NPI assigned

Oct 31, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mario Funicelli, D.C.

Title

Owner

Phone

77189487811

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1750560371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4280 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103126526",
            "telephone_number": "718-948-7811",
            "fax_number": "718-948-1018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4280 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103126526",
            "telephone_number": "718-948-7811",
            "fax_number": "718-948-1018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCEANSIDE CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "FUNICELLI",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "77189487811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X007427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Oct 31, 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.