Provider Demographics
NPI:1083760961
Name:LAJEUNESSE-DUNCAN, EMILY S (DC)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:S
Last Name:LAJEUNESSE-DUNCAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:EMILY
Other - Middle Name:S
Other - Last Name:LAJEUNESSE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:134 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:MECHANICVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12118-2526
Mailing Address - Country:US
Mailing Address - Phone:518-664-3961
Mailing Address - Fax:
Practice Address - Street 1:134 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:MECHANICVILLE
Practice Address - State:NY
Practice Address - Zip Code:12118-2526
Practice Address - Country:US
Practice Address - Phone:518-664-3961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010225111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYIA 1166OtherMEDICARE PTAN