Dr Beau Anthony Gregersen, DC | |
330 W 58th St, Suite# 407, New York, NY 10019-1827 | |
(212) 765-6470 | |
(212) 333-7346 |
Full Name | Dr Beau Anthony Gregersen |
---|---|
Gender | Male |
Speciality | Chiropractor |
Location | 330 W 58th St, 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 |
---|---|---|---|
1013056456 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | X011304-1 (New York) | Secondary |
111N00000X | Chiropractor | 10129 (Texas) | Primary |
Provider Name | Gregersen Family Chiropractic Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1922362177 PECOS PAC ID: 0042468217 Enrollment ID: O20120912000689 |
Mailing Address | Practice Location Address |
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Dr Beau Anthony Gregersen, DC 330 W 58th St, Suite# 407, New York, NY 10019-1827 Ph: (212) 765-6470 | Dr Beau Anthony Gregersen, DC 330 W 58th St, Suite# 407, New York, NY 10019-1827 Ph: (212) 765-6470 |
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