Diana Vavikova, DC | |
1 Maiden Lane, 4th Floor, New York, NY 10038-3563 | |
(212) 791-3388 | |
(888) 268-2484 |
Full Name | Diana Vavikova |
---|---|
Gender | Female |
Speciality | Chiropractor - Independent Medical Examiner |
Location | 1 Maiden Lane, 4th Floor, New York, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1750579538 | NPI | - | NPPES |
X009246 | Other | NY | LISCENSCE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111NI0013X | Chiropractor - Independent Medical Examiner | X009246 (New York) | Primary |
111N00000X | Chiropractor | X009246 (New York) | Secondary |
Provider Name | Modern Chiropractic Pc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1396750972 PECOS PAC ID: 3577582469 Enrollment ID: O20051121000694 |
Mailing Address | Practice Location Address |
---|---|
Diana Vavikova, DC 1 Maiden Lane, 4th Floor, New York, NY 10038 Ph: (212) 791-3388 | Diana Vavikova, DC 1 Maiden Lane, 4th Floor, New York, NY 10038-3563 Ph: (212) 791-3388 |
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