# JAEHO SHIN CHIROPRACTIC, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467741074
- **Authorized official:** DR. JAEHO SHIN DC (PRESIDENT)
- **Authorized official phone:** (347) 732-0396

## Contact information

- **Practice address:** 4110 163RD ST FL 1, FLUSHING, NY 11358-2606
- **Practice address phone:** (347) 732-0396
- **Practice address fax:** (347) 732-9172
- **Mailing address:** 4110 163RD ST FL 1, FLUSHING, NY 11358-2606
- **Mailing address phone:** (347) 732-0396
- **Mailing address fax:** (347) 732-9172

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | X011688 | NY | Yes |

## Other

- **Enumeration date:** 04/04/2011
- **Last updated:** 04/04/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1679703979 | NPI | NY |