Provider Demographics
NPI:1174780795
Name:CROMPOND CHIROPRACTIC P C
Entity type:Organization
Organization Name:CROMPOND CHIROPRACTIC P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FLOYD
Authorized Official - Middle Name:E
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:914-737-0176
Mailing Address - Street 1:2117 CROMPOND RD
Mailing Address - Street 2:STE# 11
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-4316
Mailing Address - Country:US
Mailing Address - Phone:914-737-0176
Mailing Address - Fax:914-737-0383
Practice Address - Street 1:2117 CROMPOND RD
Practice Address - Street 2:STE# 11
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4316
Practice Address - Country:US
Practice Address - Phone:914-737-0176
Practice Address - Fax:914-737-0383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWZYWP1Medicare PIN