Organization
BAYSIDE CHIROPRACTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELINDA KELLER DC (OWNER)
(718) 279-9485
Entity
Organization
Contact information
Practice address
21015 NORTHERN BLVD, BAYSIDE, NY 11361-3239
(718) 279-9485
(718) 279-0986
Mailing address
21015 NORTHERN BLVD, BAYSIDE, NY 11361-3239
(718) 279-9485
(718) 279-0986
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X002968-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BAZ0S306Y10
BCBS
NY
Enumeration date
02/20/2007
Last updated
07/09/2008
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