Provider Demographics
NPI:1043331986
Name:CERABINO, ANTHONY J (LAC, LMT)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:J
Last Name:CERABINO
Suffix:
Gender:M
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 MONTAUK HWY
Mailing Address - Street 2:SUITE 13
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-5102
Mailing Address - Country:US
Mailing Address - Phone:631-665-1666
Mailing Address - Fax:
Practice Address - Street 1:260 MONTAUK HWY
Practice Address - Street 2:SUITE 13
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706
Practice Address - Country:US
Practice Address - Phone:631-665-1666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003172171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist