Provider Demographics
NPI:1871557868
Name:BLOCK, JEFFREY MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:MICHAEL
Last Name:BLOCK
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 1:301 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-4900
Mailing Address - Country:US
Mailing Address - Phone:631-543-0004
Mailing Address - Fax:
Practice Address - Street 1:301 MAPLE AVE.
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787
Practice Address - Country:US
Practice Address - Phone:631-543-0004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6746-1111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
113151304OtherANTHEM
113151304OtherGHI
113151304OtherISLAND GROUP ADMINISTRATO
113151304OtherLOCAL 1199
113151304OtherLANDMARK
3C1588OtherHEALTHNET
113151304OtherBEECH STREET
P6455574OtherOXFORD
113151304OtherHORIZON
113151304OtherLOCAL 707
113151304OtherMAGNACARE
113151394OtherAFFORDABLE
1003555OtherASHN
1012459OtherUNITED HEALTHCARE
113151304OtherTHE EMPIRE PLAN
NY543597OtherAETNA
7401552113OtherCIGNA
113151304OtherJJ NEWMAN
113151304OtherLAWRENCE HEALTHCARE
113151304OtherMAGNACARE