Provider Demographics
NPI:1548544596
Name:DR ANTHONY BIZ CHIROPRACTIC WELLNESS PLLC
Entity type:Organization
Organization Name:DR ANTHONY BIZ CHIROPRACTIC WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:D
Authorized Official - Last Name:BIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-531-4325
Mailing Address - Street 1:153 BEACH 123RD ST
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1837
Mailing Address - Country:US
Mailing Address - Phone:718-531-4325
Mailing Address - Fax:646-435-2418
Practice Address - Street 1:2083 E 65TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5913
Practice Address - Country:US
Practice Address - Phone:718-531-4325
Practice Address - Fax:646-435-2418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-07
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009371111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100074721Medicare PIN