Lake Chiropractic, Pllc. | |
201 Portion Rd, Suite A, Lake Ronkonkoma, NY 11779-4172 | |
(631) 981-1333 | |
(631) 981-6766 |
Full Name | Lake Chiropractic, Pllc. |
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Type | Facility |
Speciality | Chiropractor |
Location | 201 Portion Rd, Lake Ronkonkoma, 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 |
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1972803104 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | X2929 (New York) | Primary |
Provider Name | Paul D Ravener |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1104916998 PECOS PAC ID: 6103990023 Enrollment ID: I20080811000246 |
Provider Name | Ronald R Bernardini |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1639177918 PECOS PAC ID: 9133220395 Enrollment ID: I20110221000308 |
Mailing Address | Practice Location Address |
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Lake Chiropractic, Pllc. 201 Portion Rd, Suite A, Lake Ronkonkoma, NY 11779-4172 Ph: (631) 981-1333 | Lake Chiropractic, Pllc. 201 Portion Rd, Suite A, Lake Ronkonkoma, NY 11779-4172 Ph: (631) 981-1333 |
Dr. Misti Lee Millar-calderon, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 4974 Express Dr S, Lake Ronkonkoma, NY 11779 Phone: 631-467-5515 | |
Ronald R Bernardini, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 201 Portion Rd, Lake Ronkonkoma, NY 11779 Phone: 631-981-1333 Fax: 631-981-6766 | |
Dr. Debra Hoolahan, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 95 Arlington Rd, Lake Ronkonkoma, NY 11779 Phone: 631-672-8064 |