Organization Active NPI

Central Suffolk Spine & Sports Chiropractic

  • Chiropractor
  • Brentwood, NY
National Provider Identifier
1790449643
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CENTRAL SUFFOLK SPINE & SPORTS CHIROPRACTIC
Practice address
55 Second Avenue
Suite 1
Brentwood, NY 11717
Phone
(631) 617-5733
Fax
(631) 617-5731
NPI assigned
Oct 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Authorized official

Name
Dr. Matthew Joseph Viso, DCNPI 1356377618
Title
Partner
Phone
(631) 617-5733

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

55 Second Avenue
Suite 1
Brentwood, NY 11717

Mailing address

55 Second Avenue
Suite 1
Brentwood, NY 11717
Phone (631) 617-5733

National Provider Directory

National Provider Directory

Locations

55 2nd Ave
Unit 1
Brentwood, NY 11717
Phone (516) 939-0212

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635292800000",
    "number": "1790449643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 SECOND AVENUE",
            "address_2": "SUITE 1",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "11717",
            "telephone_number": "631-617-5733",
            "fax_number": "631-617-5731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 SECOND AVENUE",
            "address_2": "SUITE 1",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "11717",
            "telephone_number": "631-617-5733",
            "fax_number": "631-617-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL SUFFOLK SPINE & SPORTS CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A",
        "authorized_official_last_name": "VISO",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "631-617-5733",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.