RONKONKOMA CHIROPRACTIC PC (NPI# 1649620709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649620709 |
| Entity Type | Organization |
| Organization Name | RONKONKOMA CHIROPRACTIC PC |
| Practice Address |
3075 Veterans Memorial Hwy Ronkonkoma NY 11779-7667 |
| Mailing Address |
3075 Veterans Memorial Hwy Suite 101 Ronkonkoma NY 11779-7667 |
| Practice Telephone | 6314722696 |
| Mailing Telephone | 6314722696 |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2016-07-28 |
| Authorized Official Name | DR. EUGENE RUSSELL FAILLACE (PRESIDENT) |
| Authorized Official Telephone | 6314722696 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 110948 | NY | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | LICENSE | X007958 | 01 |
| Street Address |
3075 VETERANS MEMORIAL HWY |
| City | RONKONKOMA |
| State | NY |
| Zip Code | 11779-7667 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669684734 | Prime Diagnostic Imaging Corp. | Clinic/Center | 3075 Veterans Memorial Hwy, Suite 160, Ronkonkoma, NY 11779-7667 | 2007-05-03 |
| 1902331614 | Anu Joy | Physical Therapist | 3075 Veterans Memorial Hwy, Suite 101, Ronkonkoma, NY 11779-7667 | 2017-05-01 |
| 1396161691 | Premier Home Health Care Services, Inc. | Registered Nurse | 3075 Veterans Memorial Hwy, Suite 180, Ronkonkoma, NY 11779-7667 | 2014-03-11 |
| 1467715284 | Iron Clad Medical Diagnostic P.C. | Specialist | 3075 Veterans Memorial Hwy, Suite 161, Ronkonkoma, NY 11779-7667 | 2012-06-18 |
| 1013238690 | Neurorays Imaging, P.C. | Internal Medicine | 3075 Veterans Memorial Hwy, Suite 160, Ronkonkoma, NY 11779-7667 | 2010-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750929139 | Sebastian Godinez | Student in an Organized Health Care Education/Training Program | 11 First Street, Ronkonkoma, NY 11779 | 2019-12-16 |
| 1487149860 | John Deming | Student in an Organized Health Care Education/Training Program | 142 - 02 20th Avenue, Flushing, NY 11779 | 2018-06-27 |
| 1376060392 | Janine D'annunzio | Specialist | 316 Thirft Street, Ronkonkoma, NY 11779 | 2017-08-30 |
| 1932621935 | Vincent Joseph Lopreto | Counselor | 253 Lake Shore Road, Ronkonkoma, NY 11779 | 2017-07-11 |
| 1598295271 | Dalas Taddeo | Licensed Practical Nurse | 4490 Express Drive S, Ronkonkoma, NY 11779 | 2017-06-15 |
| 1790214112 | Pamela Ferrante | Social Worker | 131 Avenue D, Ronkonkoma, NY 11779 | 2017-06-08 |
| 1255868915 | Bari Home Care LLC | Health Maintenance Organization | 4417 Express Drive North, Ronkonkoma, NY 11779 | 2017-05-12 |
| 1013441328 | Caring Hands Home Care | Nursing Facility/Intermediate Care Facility | 65 Cheryl Drive, Ronkonkoma, NY 11779 | 2017-04-13 |
| 1831552025 | Jacqueline Galdamez | Social Worker | 979 Johnson Avenue, Ronkonkoma, NY 11779 | 2016-04-04 |
| 1891192530 | Alex Mitchell Pollack | Massage Therapist | 34 Richmond Blvd, #3a, Ronkonkoma, NY 11779 | 2014-11-24 |
| Find all providers in zip 11779 | ||||
| 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 |
|---|---|---|---|---|
| 1124143623 | Michael William Smith | Chiropractor | 700 Union Pkwy Ste 3, Ronkonkoma, NY 11779-7427 | 2007-03-21 |
| 1154461986 | William Ray IIi | Chiropractor | 879 Johnson Ave, Ronkonkoma, NY 11779-6053 | 2007-02-08 |
| 1679664262 | Bruce Berns | Chiropractor | 2805 Veterans Hwy, Ste 8, Ronkonkoma, NY 11779-7680 | 2006-09-27 |
| 1922056688 | Joseph L Adamo | Chiropractor | 4671 Express Dr N, Ronkonkoma, NY 11779-5562 | 2006-05-05 |
| 1164488896 | Eugene Russell Faillace | Chiropractor | 3075 Veterans Memorial Hwy Ste 101, Ronkonkoma, NY 11779-7600 | 2006-04-21 |
| 1821079344 | Louis Lupinacci | Chiropractor | 352 Rosevale Ave, Ronkonkoma, NY 11779 | 2005-11-10 |
| 1952863458 | Urgent Chiropractic P.C. | Chiropractor | 2805 Veterans Memorial Hwy Ste 8, Ronkonkoma, NY 11779-7680 | 2019-04-03 |
| 1992215222 | Li Integrated Chiropractic Physical Therapy & Acupuncture | Chiropractor | 2805 Veterans Memorial Hwy Ste 8, Ronkonkoma, NY 11779-7680 | 2017-09-29 |
| 1467980771 | Connetquot Pt & Chiropractic Pllc | Chiropractor | 2805 Veterans Hwy, Ronkonkoma, NY 11779-7647 | 2017-05-31 |
| 1164971297 | Structure Pro Chiropractic P.C. | Chiropractor | 2805 Veterans Memorial Hwy, #8, Ronkonkoma, NY 11779-7647 | 2016-09-30 |
| Find all providers in RONKONKOMA | ||||
| City | RONKONKOMA |
| Zip Code | 11779 |
Please comment or provide details below to improve the information on RONKONKOMA CHIROPRACTIC PC.
| 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.