Provider Demographics
NPI:1144404906
Name:BROOKLYN CHIROPRACTIC LLC
Entity type:Organization
Organization Name:BROOKLYN CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:GALATI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:216-635-0653
Mailing Address - Street 1:5592 BROADVIEW RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44134-1677
Mailing Address - Country:US
Mailing Address - Phone:216-635-0653
Mailing Address - Fax:216-741-7639
Practice Address - Street 1:5592 BROADVIEW RD
Practice Address - Street 2:SUITE 107
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134-1677
Practice Address - Country:US
Practice Address - Phone:216-635-0653
Practice Address - Fax:216-741-7639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2721111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHBR9352691Medicare PIN