Provider Demographics
NPI:1235171935
Name:MACOLINO, LOUIS LAWRENCE II (DC)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:LAWRENCE
Last Name:MACOLINO
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:538 3RD ST
Mailing Address - Street 2:
Mailing Address - City:E NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-2427
Mailing Address - Country:US
Mailing Address - Phone:718-726-0328
Mailing Address - Fax:718-726-0419
Practice Address - Street 1:2120 33RD RD
Practice Address - Street 2:SUITE 1A
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-4247
Practice Address - Country:US
Practice Address - Phone:718-726-0328
Practice Address - Fax:718-726-0419
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007815111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU69833Medicare UPIN
NY02741HMedicare PIN