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Organization
NEW YORK INJURY CHIROPRACTIC REHAB PC
Active
Organization
NEW YORK INJURY CHIROPRACTIC REHAB PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AVIANNE WAITHE DC (CHIROPRACTIC DOCTOR/AO)
(443) 622-9429
Entity
Organization
Contact information
Practice address
3723 72ND ST FL 1, JACKSON HEIGHTS, NY 11372-6126
(718) 255-1533
Mailing address
3723 72ND ST FL 1, JACKSON HEIGHTS, NY 11372-6126
(443) 622-9429
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
—
NULL
111NR0400X
Rehabilitation Chiropractor
Primary
—
—
111NX0800X
Orthopedic Chiropractor
—
NULL
111NX0800X
Orthopedic Chiropractor
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
NULL
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
—
247200000X
Other Technician
—
NULL
247200000X
Other Technician
—
—
Other
Enumeration date
07/27/2023
Last updated
09/15/2023
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