Provider Demographics
NPI:1528350600
Name:NATURAL CHIROPRACTIC CARE PC
Entity type:Organization
Organization Name:NATURAL CHIROPRACTIC CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:DC,DIBE
Authorized Official - Phone:718-585-0306
Mailing Address - Street 1:PO BOX 40693
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-0693
Mailing Address - Country:US
Mailing Address - Phone:862-324-5764
Mailing Address - Fax:
Practice Address - Street 1:2901 3RD AVE
Practice Address - Street 2:C/O DR. SHARON RICH
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-2638
Practice Address - Country:US
Practice Address - Phone:718-585-0306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-09
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY700008734111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02011452Medicaid
NYX0A412OtherEMPIRE BC/BS
NY0571154OtherCIGNA
NYX0A411OtherMEDICARE
NY02011452Medicaid