Organization
OPTIMAL CHIROPRACTIC ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS CHARLES BAVARO DC (CHIROPRACTOR)
(718) 433-2399
Entity
Organization
Contact information
Practice address
4601 43RD AVE, SUNNYSIDE, NY 11104-1507
(718) 433-2399
(718) 433-0483
Mailing address
4601 43RD AVE, SUNNYSIDE, NY 11104-1507
(718) 433-2399
(718) 433-0483
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
X008794
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02090540
—
NY
Enumeration date
04/23/2008
Last updated
12/09/2008
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