Integral Performance Chiropractic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

70 011933 Issued in NY

Legal business name

INTEGRAL PERFORMANCE CHIROPRACTIC PC

Practice address

235 Dongan Hills Ave
Suite 1E
Staten Island, NY 10305-1246

Phone

(718) 351-5400

Fax

(718) 351-5433

NPI assigned

Jun 19, 2012

Organization subpart

No

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

Authorized official

Name

Alex Kazhdan, DCNPI 1093017972

Title

Owner

Phone

(718) 351-5400

Specialties & licenses 2

Addresses

Other names 1

• Integral Health and Wellness Other name

Locations

Practitioners 1

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

• Alex Kazhdan, D.C., L.M.T.

  • Chiropractor
  • Staten Island, NY
  • NPI 1093017972
  NPD (past) Authorized official

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340064000000",
    "number": "1831452473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 DONGAN HILLS AVE",
            "address_2": "SUITE 1E",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051246",
            "telephone_number": "718-351-5400",
            "fax_number": "718-351-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 DONGAN HILLS AVE",
            "address_2": "SUITE 1E",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051246",
            "telephone_number": "718-351-5400",
            "fax_number": "718-351-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRAL PERFORMANCE CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-19",
        "last_updated": "2012-06-19",
        "status": "A",
        "authorized_official_last_name": "KAZHDAN",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-351-5400",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "70 011933",
            "primary": true
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integral Health and Wellness",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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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 Jun 19, 2012; 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.