# INTEGRATED CHIROPRACTIC AND PHYSICAL THERAPY ASSOCIATES PLLC

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

## Provider details

- **NPI number:** 1962762591
- **Authorized official:** KELLY-ANN FLYNN (OFFICE MANAGER)
- **Authorized official phone:** (212) 475-8104

## Contact information

- **Practice address:** 10 E 21ST ST STE 1106, NEW YORK, NY 10010-7181
- **Practice address phone:** (212) 475-8104
- **Practice address fax:** (212) 475-4443
- **Mailing address:** 10 E 21ST ST STE 1106, NEW YORK, NY 10010-7181
- **Mailing address phone:** (212) 475-8104
- **Mailing address fax:** (212) 475-4443

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | X008846 | NY | Yes |
| 225100000X | Physical Therapist | 440113063 | NY | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 05/16/2012
- **Last updated:** 06/12/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1083891741 | CHIROPRACTOR | NY |
| 01 | — | 1295204923 | PHYSICAL THERAPY | NY |
| 01 | — | 1730664897 | PHYSICAL THERAPY | NY |
| 01 | — | 1740788504 | NURSE PRACTITIONER | NY |