Individual
DIANA VAVIKOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
1 MAIDEN LANE, 4TH FLOOR, NEW YORK, NY 10038-3563
(212) 791-3388
(888) 268-2484
Mailing address
1 MAIDEN LANE, 4TH FLOOR, NEW YORK, NY 10038
(212) 791-3388
(888) 268-2484
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
X009246
NY
111NI0013X
Independent Medical Examiner Chiropractor
Primary
X009246
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X009246
LISCENSCE
NY
Enumeration date
10/05/2007
Last updated
12/12/2011
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