| |
1065 Old Country Rd, Suite 214, Westbury, NY 11590-5640 | |
(516) 334-7000 | |
(516) 334-7082 |
Full Name | |
---|---|
Type | Facility |
Speciality | Physical Medicine & Rehabilitation |
Location | 1065 Old Country Rd, Westbury, New York |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1194906370 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | X008423 (New York) | Secondary |
208100000X | Physical Medicine & Rehabilitation | A193731-1 (New York) | Primary |
Provider Name | Engracia O Lazatin |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1265474837 PECOS PAC ID: 2365488152 Enrollment ID: I20111005000070 |
Provider Name | Stephen Athan |
---|---|
Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1063500155 PECOS PAC ID: 2466467816 Enrollment ID: I20130506000167 |
Mailing Address | Practice Location Address |
---|---|
1065 Old Country Rd, Suite 214, Westbury, NY 11590-5640 Ph: (516) 334-7000 | 1065 Old Country Rd, Suite 214, Westbury, NY 11590-5640 Ph: (516) 334-7000 |