HEAD TO TOE CHIROPRACTIC, PLLC (NPI# 1508306333) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508306333 |
| Entity Type | Organization |
| Organization Name | HEAD TO TOE CHIROPRACTIC, PLLC |
| Other Organization Name | OPTIMUM CHIROPRACTIC CENTER |
| Practice Address |
2500 Nesconset Highway Building 9b Stony Brook NY 11790 |
| Practice Telephone | 6316890049 |
| Practice Fax Number | 6316890071 |
| Mailing Telephone | 6316890049 |
| Mailing Fax Number | 6316890071 |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2017-02-27 |
| Authorized Official Name | DR. SUSAN TARA MACKEY (OWNER) |
| Authorized Official Telephone | 6316890049 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | X007538-1 | NY | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | WORKERS COMPENSATION | C075384 | 01 |
| BC/BS | X97331 | 01 | |
| GHI | 5899840 | 01 |
| Other Name | Type Code |
|---|---|
| Optimum Chiropractic Center | Doing Business As Name - Organization |
| Street Address |
2500 NESCONSET HIGHWAY BUILDING 9B |
| City | STONY BROOK |
| State | NY |
| Zip Code | 11790 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356682652 | Mark-mina M Ishak | Neurological Surgery | 2500 Nesconset Highway, Building 18c, Stony Brook, NY 11790 | 2013-03-12 |
| 1194947085 | Dawn M Diecidue | Nurse Practitioner | 2500 Nesconset Highway, Building 23, Stony Brook, NY 11790 | 2007-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649807678 | Ribu Mathew | Student in an Organized Health Care Education/Training Program | Health Science Center T16, Room 020, Stony Brook, NY 11790 | 2020-03-27 |
| 1538794821 | Chaoyang Qu | Student in an Organized Health Care Education/Training Program | 9 Syncamore Dr, Stonybrook, NY 11790 | 2020-03-06 |
| 1457814824 | Brain & Spine Surgery, P.C. | Neurological Surgery | 2500 Nesconset Hwy., Bldg 18c, Stony Brook, NY 11790 | 2019-04-11 |
| 1447759741 | Susan Cuccia | Registered Nurse | 40 Sheppard Lane, Stony Brook, NY 11790 | 2018-02-02 |
| 1972022234 | Carol M Doherty | Specialist | 7 Haskel Lane, Stony Brook, NY 11790 | 2017-09-18 |
| 1972021582 | Louren M Gonzales | Nurse Practitioner | 100 Nicolls Rd Hsc Level 4 Room 120, Hsc Level 4 Room 120, Stony Brook, NY 11790 | 2017-09-04 |
| 1043740954 | Asma Khattak | Behavior Technician | 90 Quaker Path, Stony Brook, NY 11790 | 2017-06-13 |
| 1427452846 | Christina Georgia | Registered Nurse | 36 Ivy League Lane, Stony Brook, NY 11790 | 2014-10-14 |
| 1124361654 | Mandeep Kainth | Student in an Organized Health Care Education/Training Program | Department of Medicine Hsc Level 16, 020, Suny Stony Brook, Stony Brook, NY 11790 | 2013-04-03 |
| 1922357144 | Audry M Luciano | Registered Nurse | 2500 Nesconset Hwy Bldg 23, Stony Brook, NY 11790 | 2012-09-04 |
| Find all providers in zip 11790 | ||||
| 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 |
|---|---|---|---|---|
| 1447514609 | Brandon Michael Henkowicz | Chiropractor | 2500 Nesconset Hwy Bldg 9b, Stony Brook, NY 11790-2553 | 2012-07-02 |
| 1811023336 | Richard C Rugen | Chiropractor | 1556 Stony Brook Rd, Stony Brook, NY 11790-0571 | 2007-02-26 |
| 1912092883 | Matthew A Aron | Chiropractor | 19 Sanford Ln, Suite M, Stony Brook, NY 11790-3303 | 2006-10-04 |
| 1417471202 | Brandon M Henkowicz Dc, P.C. | Chiropractor | 2500 Nesconset Hwy, Stony Brook, NY 11790-2555 | 2017-08-02 |
| 1811329188 | Diana Palamar | Chiropractor | 213 Hallock Rd, Suite 4b, Stony Brook, NY 11790-3000 | 2013-08-08 |
| 1063859619 | Leon Chiropractic P.C. | Chiropractor | 213 Hallock Rd, Suite 4b, Stony Brook, NY 11790-3000 | 2013-05-22 |
| 1275979387 | Stonybrook Regional Chiropractic PC | Chiropractor | 2500 Nesconset Hwy, Building 20a, Stony Brook, NY 11790-2555 | 2013-05-15 |
| 1730331349 | David Marlin Levi | Chiropractor | 207 Hallock Rd, Suite 160, Stony Brook, NY 11790-3033 | 2008-10-14 |
| 1316067424 | Jared Adam Leon | Chiropractor | 213 Hallock Rd, Suite 4b, Stony Brook, NY 11790-3000 | 2007-03-30 |
| 1780713362 | Island Chiropractic Pain Care | Chiropractor | 1320 Stony Brook Rd, Suite 26, Stony Brook, NY 11790-2206 | 2007-03-02 |
| Find all providers in STONY BROOK | ||||
| City | STONY BROOK |
| Zip Code | 11790 |
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| 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.