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Organization
SRN CHIROPRACTIC, PC
Active
Organization
SRN CHIROPRACTIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORNELIA KRIEGER (PROVIDER COORDINATOR)
(914) 328-8077
Entity
Organization
Contact information
Practice address
6517 MYRTLE AVE, GLENDALE, NY 11385-6248
(718) 497-1150
(718) 417-0912
Mailing address
174 GRAND ST, WHITE PLAINS, NY 10601-4803
(914) 328-8077
(914) 328-6083
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X006877-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07869
GHI MEDICARE
NY
Enumeration date
10/05/2006
Last updated
04/23/2008
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