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Organization

REGO PARK CHIROPRACTIC PC

Active
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Organization

REGO PARK CHIROPRACTIC PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DIANE M RENZULLI DC (PRES)
(718) 803-2300
Entity
Organization

Contact information

Practice address
6298 WOODHAVEN BLVD, REGO PARK, NY 11374-3738
(718) 803-2300
(718) 565-2875
Mailing address
6298 WOODHAVEN BLVD, REGO PARK, NY 11374-3738
(718) 803-2300
(718) 565-2875

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X004316-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0058574
GHI
01
CO43168B
WC NY
NY
Enumeration date
01/26/2007
Last updated
11/20/2008
About Stedi
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  • EDI platform