Provider Demographics
NPI:1043548597
Name:KEITH & DEAN CHIROPRACTIC CARE PLLC
Entity type:Organization
Organization Name:KEITH & DEAN CHIROPRACTIC CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:646-373-7702
Mailing Address - Street 1:790A UNION ST
Mailing Address - Street 2:#A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-1307
Mailing Address - Country:US
Mailing Address - Phone:718-230-4842
Mailing Address - Fax:718-230-4834
Practice Address - Street 1:790A UNION ST
Practice Address - Street 2:#A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-1307
Practice Address - Country:US
Practice Address - Phone:718-230-4842
Practice Address - Fax:718-230-4834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009347261QH0100X, 261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX6H061Medicare PIN
NYU96428Medicare UPIN