Provider Demographics
NPI:1023144516
Name:MUENCH, PHILIP F (DC)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:F
Last Name:MUENCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 ROUTE 109
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-1157
Mailing Address - Country:US
Mailing Address - Phone:631-225-4878
Mailing Address - Fax:631-225-3109
Practice Address - Street 1:714 ROUTE 109
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-1157
Practice Address - Country:US
Practice Address - Phone:631-225-4878
Practice Address - Fax:631-225-3109
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX-006874111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX-006874OtherLICENSE NUMBER
NYX-006874OtherLICENSE NUMBER
NYX48351Medicare ID - Type Unspecified