Provider Demographics
NPI:1043268824
Name:KANEVSKY, ALEKSANDER (DC)
Entity type:Individual
Prefix:
First Name:ALEKSANDER
Middle Name:
Last Name:KANEVSKY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E 55TH ST
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-4514
Mailing Address - Country:US
Mailing Address - Phone:917-748-5279
Mailing Address - Fax:
Practice Address - Street 1:150 E 55TH ST
Practice Address - Street 2:6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4514
Practice Address - Country:US
Practice Address - Phone:917-748-5279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009212111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU93795Medicare UPIN
NYX5R671Medicare ID - Type UnspecifiedCHIROPRACTOR