Individual
DR. JEREMY TJANDRA SUBADYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
353 LEXINGTON AVE RM 1005, NEW YORK, NY 10016-0941
(212) 293-1722
Mailing address
353 LEXINGTON AVE RM 1005, NEW YORK, NY 10016-0941
(212) 293-1722
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
012806
NY
111N00000X
Chiropractor
32396
CA
Other
Enumeration date
07/12/2016
Last updated
07/12/2016
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