Provider Demographics
NPI:1245913797
Name:UPPER WEST SIDE CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:UPPER WEST SIDE CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:AMMITAI
Authorized Official - Middle Name:
Authorized Official - Last Name:WOROB
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:607-269-7221
Mailing Address - Street 1:279 CENTRAL PARK W # 1A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3080
Mailing Address - Country:US
Mailing Address - Phone:212-877-1711
Mailing Address - Fax:212-877-1971
Practice Address - Street 1:279 CENTRAL PARK W # 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3080
Practice Address - Country:US
Practice Address - Phone:212-877-1711
Practice Address - Fax:212-877-1971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty