Provider Demographics
NPI:1871729012
Name:EDWARD J. GORECKI, DC, PLLC
Entity type:Organization
Organization Name:EDWARD J. GORECKI, DC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:GORECKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:917-414-9113
Mailing Address - Street 1:853 BROADWAY STE 1601
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:853 BROADWAY
Practice Address - Street 2:SUITE 1601
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4703
Practice Address - Country:US
Practice Address - Phone:917-414-9113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-02
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010272-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty