# MALTA CHIROPRACTIC PC

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

## Provider details

- **NPI number:** 1790283182
- **Authorized official:** DR. WAQAS PERVAIZ DC (CHIROPRACTOR)
- **Authorized official phone:** (518) 289-5229

## Contact information

- **Practice address:** 10 BLACKSMITH DR STE 1, BALLSTON SPA, NY 12020-4428
- **Practice address phone:** (518) 289-5229
- **Mailing address:** 10 BLACKSMITH DR STE 1, BALLSTON SPA, NY 12020-4428
- **Mailing address phone:** (518) 289-5229

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | X012859-1 | NY | Yes |
| 111NR0400X | Rehabilitation Chiropractor | X006175-1 | NY | — |

## Other

- **Enumeration date:** 01/31/2018
- **Last updated:** 06/20/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1447301049 | NPI | NY |