Provider Demographics
NPI:1184845984
Name:DR.LLOYD CHARLES REITER, D.C. P.C.
Entity Type:Organization
Organization Name:DR.LLOYD CHARLES REITER, D.C. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:REITER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:631-758-8770
Mailing Address - Street 1:1731 N OCEAN AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:MEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11763-2670
Mailing Address - Country:US
Mailing Address - Phone:631-758-8770
Mailing Address - Fax:631-758-8769
Practice Address - Street 1:1731 N OCEAN AVE
Practice Address - Street 2:SUITE C
Practice Address - City:MEDFORD
Practice Address - State:NY
Practice Address - Zip Code:11763-2670
Practice Address - Country:US
Practice Address - Phone:631-758-8770
Practice Address - Fax:631-758-8769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4384-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty