DIVINE CHIROPRACTIC LLC (NPI# 1235404039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235404039 |
| Entity Type | Organization |
| Organization Name | DIVINE CHIROPRACTIC LLC |
| Practice Address |
465 Route 25a Suite 1 Miller Place NY 11764 |
| Practice Telephone | 6313842023 |
| Mailing Telephone | 6313842023 |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2012-03-13 |
| Authorized Official Name | DR. KATHLEEN CAREY CLARKIN-DEDIO (OWNER) |
| Authorized Official Telephone | 6313842023 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | X011437-1 | NY | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457649857 | Divine Chiropractic LLC | Preferred Provider Organization | 404 North John F Kennedy Avenue, Loogootee, IN 47553 | 2011-07-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | DIVINE CHIROPRACTIC LLC | 404 N Jfk Ave., Loogootee, IN 47553 |
| Street Address |
465 ROUTE 25A SUITE 1 |
| City | MILLER PLACE |
| State | NY |
| Zip Code | 11764 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174132377 | Keith Scott Alloy | Massage Therapist | 465 Route 25a, Unit 1, Miller Place, NY 11764 | 2020-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689151870 | Jjr Lifecare Inc | In Home Supportive Care | 85 Echo Ave., Suite 5, Miller Place, NY 11764 | 2018-07-20 |
| 1447782172 | Xuxin Zhang | Dentist | 555 Ny-25a, Miller Place, NY 11764 | 2017-03-31 |
| 1679972202 | Tara Daniels | Social Worker | 595-20 Route 25a, Suite 20, Miller Place, NY 11764 | 2014-08-20 |
| 1063858355 | Karen Ann Mcnulty | Specialist | 16 White Birch Circle, Miller Place, NY 11764 | 2013-05-14 |
| 1689918070 | Katja Mercado | Speech-Language Pathologist | 3 Honey Lane, Miller Place, NY 11764 | 2012-11-26 |
| 1447526967 | North Isle Chiropractic PC | Chiropractor | 93 Miller Place Rd., Miller Place, NY 11764 | 2012-03-29 |
| 1124338611 | Lisa Aitken | Social Worker | 15 Memorial Drive, Miller Place, NY 11764 | 2010-10-18 |
| 1659504876 | Janet Lynn Karp | Speech-Language Pathologist | 36 Samuels Path, Miller Place, NY 11764 | 2009-09-04 |
| 1356577589 | Marilee Somerville | Physical Therapist | 36 Sweetgum Ln, Miller Place, NY 11764 | 2009-06-02 |
| 1346416021 | Wahid Rashidzada | Psychiatry & Neurology | 595 Route 25a Ste 2, Miller Place, NY 11764 | 2008-05-02 |
| Find all providers in zip 11764 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447526967 | North Isle Chiropractic PC | Chiropractor | 93 Miller Place Rd., Miller Place, NY 11764 | 2012-03-29 |
| 1396921276 | Jennifer Elsholz | Chiropractor | 85 Echo Ave Ste 4, Miller Place, NY 11764-2200 | 2008-01-10 |
| 1992908685 | Richard Frederick Ebbrecht | Chiropractor | 45 Sylvan Ave, Miller Place, NY 11764-1929 | 2007-06-08 |
| 1356491468 | Thomas J Ianniello | Chiropractor | 93 Miller Place Rd, Miller Place, NY 11764-2406 | 2007-01-11 |
| 1275695975 | Richard A Nebiosini | Chiropractor | 451 Route 25a, Unit 9, Miller Place, NY 11764-2500 | 2006-12-16 |
| 1538228457 | Jamie C Skaggs | Chiropractor | 54 North Country Road, Suite 4, Miller Place, NY 11764 | 2006-12-06 |
| 1437242369 | Robert Joseph Colascione | Chiropractor | 109 Echo Ave, Miller Place, NY 11764-2205 | 2006-10-02 |
| 1366543373 | Peter J. Stumpf | Chiropractor | 765 Route 25a Ste 5, Miller Place, NY 11764-2649 | 2006-09-25 |
| 1346290129 | James Vincent Masone | Chiropractor | 29 Miller Woods Dr, Miller Place, NY 11764-1524 | 2006-05-11 |
| 1588290779 | Miller Place Pt, Family Health Np and Chiropractic Pllc | Chiropractor | 41 Echo Ave, Miller Place, NY 11764-2108 | 2020-03-19 |
| Find all providers in MILLER PLACE | ||||
| City | MILLER PLACE |
| Zip Code | 11764 |
Please comment or provide details below to improve the information on DIVINE CHIROPRACTIC LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.