Individual
DR. JONATHAN TODD AMDUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
194 DEER PARK AVE, BABYLON, NY 11702-2804
(631) 321-6300
(631) 321-6338
Mailing address
194 DEER PARK AVE, BABYLON, NY 11702-2804
(631) 321-6300
(631) 321-6338
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X007446
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5897873
GHI INDIVIDUAL #
NY
01
—
C07446-0
WORKERS COMPENSATION ID #
NY
Enumeration date
10/19/2006
Last updated
08/20/2010
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