Port Jeff Station Chiropractic

LBN: Chiropractic Of Stony Brook Pllc
Port Jeff Station Chiropractic is an health care organization with primary practice located at 1041 Rout 112 , Port Jefferson Station NY 11776. The organization recently has 2 registered licenses in different health care specialties including Chiropractic Providers / Chiropractor, Ambulatory Health Care Facilities / Clinic/Center. Ambulatory Health Care Facilities / Clinic/Center is the primary health care specialty. Chiropractic Of Stony Brook Pllc can be contacted via phone (631) 828-4545, or through Bonasera, Gregory N. via phone (631) 828-4545.

Contact Information

Primary practice address
1041 Rout 112 Port Jefferson Station NY 11776
Phone: (631) 828-4545
Fax: (631) 642-1070
Website:
Map and Directions
Authorized official contact:
Name: Bonasera, Gregory N. Doctor of Chiropractic (DC)
Phone: (631) 828-4545

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X X005301-1 New York

Profile Details

NPI number 1891838538
LBN Legal business name Chiropractic Of Stony Brook Pllc
DBA Doing business as Port Jeff Station Chiropractic
Authorized official Bonasera, Gregory N. Doctor of Chiropractic (DC)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 14th, 2007
Last updated Jan 22nd, 2019 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891838538 NPPES
New York MEDICAID 01738361

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