Advanced Chiropractic Wellness Care
Organization Active NPI Chiropractor · Brewster, NY
NPI 1962765735 · NPPES record last updated Jun 18, 2012
Key facts
- NPI
- 1962765735
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- X008481-1 (NY)
- Legal business name
- ADVANCED CHIROPRACTIC WELLNESS CARE
- Practice address
- 979 Route 22
Brewster, NY 10509-1526 - Phone
- (845) 279-4300
- Fax
- (845) 582-0293
- NPI assigned
- Jun 18, 2012
- Organization subpart
- No
Authorized official
- Name
- Dr. Anne Brandon M, D.C.
- Title
- Chiropractor/Partner
- Phone
- (845) 279-4300
Practitioners 4
-
Anne Brandon, D.C.
-
Renold J Statler, D.C.
-
Jacqueline Demayo, D.C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121203000113 | NY | Part B Supplier - Clinic/Group Practice | 2264684034 |
Receives reassigned benefits from 2 practitioners Practice locations: Brewster, NY |
National Provider Directory
Locations
3951 Danbury Rd
Brewster, NY 10509
Phone (845) 279-4300
979 Route 22
Ste B
Brewster, NY 10509
Phone (845) 279-4300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | X008481-1 | NY | Yes |
Addresses
Primary practice location
979 Route 22
Brewster, NY 10509-1526
Mailing address
979 Route 22
Brewster, NY 10509-1526
Phone (845) 279-4300
Other providers in Brewster, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.