SERENITY SOURCE CHIROPRACTIC & MASSAGE PLLC (NPI# 1316350580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316350580 |
| Entity Type | Organization |
| Organization Name | SERENITY SOURCE CHIROPRACTIC & MASSAGE PLLC |
| Practice Address |
18 Weeks St Ste A Blue Point NY 11715-1513 |
| Practice Telephone | 6314047073 |
| Practice Fax Number | 6317518298 |
| Mailing Telephone | 6314047073 |
| Mailing Fax Number | 6317518298 |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2014-06-05 |
| Authorized Official Name | MISS ANTHONY PUSATERI (OWNER) |
| Authorized Official Telephone | 6314047073 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 007829 | NY | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | LICENSE | 007829 | 01 |
| Street Address |
18 WEEKS ST STE A |
| City | BLUE POINT |
| State | NY |
| Zip Code | 11715-1513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093117202 | Serenity Source Physical Therapy, Chiropractic&massage Pllc | Chiropractor | 18 Weeks St Ste A, Blue Point, NY 11715-1513 | 2014-09-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366998684 | Innocentia Nkeiruka Eke | Licensed Practical Nurse | Caring Hands Home Care Inc., 263 Blue Point Avenue, Blue Point, NY 11715 | 2016-08-28 |
| 1013381714 | Marie Solages | Licensed Practical Nurse | 263 Blue Point Avenue, Caring Hands Home Care, Blue Point, NY 11715 | 2015-11-18 |
| 1750750451 | Justine Pomponio | Early Intervention Provider Agency | 24 Norwood Drive, Blue Point, NY 11715 | 2015-09-23 |
| 1447663349 | Alicia Mantione | Behavioral Analyst | 86 Montauk Hwy, Blue Point, NY 11715 | 2014-06-09 |
| 1306013487 | S Paul Zola | Emergency Medicine | 38 W Harbour Dr, Blue Point, NY 11715 | 2008-05-08 |
| 1700924586 | David E. Konnick Jr. | Licensed Practical Nurse | 320 Bluepoint Rd., Bluepoint, NY 11715 | 2007-02-02 |
| 1417093741 | Patricia Cullon Campanelli | Speech-Language Pathologist | 235a Blue Point Ave, Blue Point, NY 11715 | 2007-01-30 |
| 1922044635 | Alejandro Alfredo Godoy | Social Worker | 20 Montauk Highway, Blue Point, NY 11715 | 2006-06-21 |
| 1669909065 | Courtney Perrone | Speech-Language Pathologist | 235 Blue Point Ave, Blue Point, NY 11715 | 2017-05-16 |
| 1578098919 | Evelyn Dwumah | Registered Nurse | 263 Blue Point, Caring Hands Home Care, Blue Point, NY 11715 | 2017-04-24 |
| Find all providers in zip 11715 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881995405 | Anthony F Pusateri Jr. | Chiropractor | 18 Weeks St, Blue Point, NY 11715-1513 | 2010-11-12 |
| 1093117202 | Serenity Source Physical Therapy, Chiropractic&massage Pllc | Chiropractor | 18 Weeks St Ste A, Blue Point, NY 11715-1513 | 2014-09-18 |
| 1700156643 | Serenity Source Chiropractic | Chiropractor | 18 Weeks St, Suite A, Blue Point, NY 11715-1513 | 2012-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750980959 | Jay Rosenbluth | Chiropractor | 501 5th Ave Rm 809, New York, NY 10017-7809 | 2020-10-20 |
| 1457959223 | Howard Joseph Baron | Chiropractor | 360 Shore Rd Apt 6b, Long Beach, NY 11561-4374 | 2020-10-14 |
| 1003414079 | Brett John Poniros | Chiropractor | 220 Tompkins Ave, Pleasantville, NY 10570-3146 | 2020-10-13 |
| 1528675923 | Dominic Estevez | Chiropractor | 361 N Broadway, Lindenhurst, NY 11757-3302 | 2020-09-29 |
| 1457963969 | Mariella Townsend | Chiropractor | 220 S Service Rd Ste 12, Roslyn Heights, NY 11577-2131 | 2020-08-18 |
| 1235740275 | Andrea Hope Levin | Chiropractor | 280 Beaumont St, Brooklyn, NY 11235-4121 | 2020-08-13 |
| 1326657354 | David Gurpegui | Chiropractor | 13263 Maple Ave Apt 2r, Flushing, NY 11355-4417 | 2020-07-27 |
| 1730797010 | Lynn Marie Viscusi | Chiropractor | 1163 Old Country Road, Plainview, NY 11803 | 2020-07-22 |
| 1700404027 | Amy J Lin | Chiropractor | 8225 Queens Blvd Ste 1a, Elmhurst, NY 11373-4242 | 2020-07-13 |
| 1124646856 | Brayana Lashay Dudley | Chiropractor | 25 Scott Ln, Rochester, NY 14624-3919 | 2020-07-09 |
| Find all providers with the same taxonomy | ||||
| City | BLUE POINT |
| Zip Code | 11715 |
Please comment or provide details below to improve the information on SERENITY SOURCE CHIROPRACTIC & MASSAGE PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.