Provider Demographics
NPI:1285839233
Name:LAMANTIA, MARC JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:JOHN
Last Name:LAMANTIA
Suffix:
Gender:M
Credentials:DC
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Mailing Address - Street 1:160 BROADWAY
Mailing Address - Street 2:16TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038
Mailing Address - Country:US
Mailing Address - Phone:212-360-7760
Mailing Address - Fax:212-360-7974
Practice Address - Street 1:160 BROADWAY
Practice Address - Street 2:16TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038
Practice Address - Country:US
Practice Address - Phone:212-360-7760
Practice Address - Fax:212-360-7974
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2020-04-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYX008247-1111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU64763Medicare UPIN