Organization Active NPI

Wem Diagnostic Chiropractic Services PC

  • Rehabilitation Chiropractor
  • Freeport, NY
National Provider Identifier
1942576210
Registry record updated Mar 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
010611 Issued in NY
Legal business name
WEM DIAGNOSTIC CHIROPRACTIC SERVICES PC
Practice address
31 Guy Lombardo Ave Ste 2
Freeport, NY 11520-3632
Phone
(516) 213-4610
Fax
(516) 213-4819
NPI assigned
Mar 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2012

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

Authorized official

Name
Dr. Walter Enrique Mendoza, DC
Title
Chiropractor
Phone
(516) 213-4610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X 010611 NY Primary

Addresses

Primary practice location

31 Guy Lombardo Ave Ste 2
Freeport, NY 11520-3632

Mailing address

31 Guy Lombardo Ave Ste 2
Freeport, NY 11520-3632
Phone (516) 213-4610

National Provider Directory

National Provider Directory

Locations

31 Guy Lombardo Ave
Ste 2
Freeport, NY 11520
Phone (516) 213-4610

NPI Registry JSON

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

{
    "created_epoch": "1333065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333065600000",
    "number": "1942576210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 GUY LOMBARDO AVE STE 2",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115203632",
            "telephone_number": "516-213-4610",
            "fax_number": "516-213-4819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 GUY LOMBARDO AVE STE 2",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115203632",
            "telephone_number": "516-213-4610",
            "fax_number": "516-213-4819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEM DIAGNOSTIC CHIROPRACTIC SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-30",
        "last_updated": "2012-03-30",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "ENRIQUE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "516-213-4610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "NY",
            "license": "010611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.