# LIFESOURCE CHIROPRACTIC P.C

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

## Provider details

- **NPI number:** 1700068491
- **Authorized official:** DR. NICHOLAS JOSEPH UNGARO DC (OWNER)
- **Authorized official phone:** (212) 286-0888

## Contact information

- **Practice address:** 535 5TH AVE, SUITE 920, NEW YORK, NY 10017-3620
- **Practice address phone:** (212) 286-0888
- **Practice address fax:** (212) 286-9726
- **Mailing address:** 535 5TH AVE, SUITE 920, NEW YORK, NY 10017-3620
- **Mailing address phone:** (917) 861-2472
- **Mailing address fax:** (866) 291-8321

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | X009921 | NY | Yes |

## Other

- **Enumeration date:** 12/04/2007
- **Last updated:** 01/06/2016