Organization
GAMMA CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER MAZUROVSKY DC (PRESIDENT)
(718) 998-3020
Entity
Organization
Contact information
Practice address
1332 FOREST AVE, STATEN ISLAND, STATEN ISLAND, NY 10302-2043
(718) 442-8813
(718) 876-0158
Mailing address
1332 FOREST AVE, STATEN ISLAND, STATEN ISLAND, NY 10302-2043
(718) 442-8813
(718) 876-0158
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
009550
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009550
LICENSE
NY
Enumeration date
09/19/2012
Last updated
09/19/2012
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