Provider Demographics
NPI:1336323930
Name:LEPOVETSKY, NEAL (DC)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:
Last Name:LEPOVETSKY
Suffix:
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 1:246 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:PA
Mailing Address - Zip Code:15857-1708
Mailing Address - Country:US
Mailing Address - Phone:814-781-7208
Mailing Address - Fax:814-781-8505
Practice Address - Street 1:246 CHESTNUT ST
Practice Address - Street 2:POST OFFICE BOX 27
Practice Address - City:SAINT MARYS
Practice Address - State:PA
Practice Address - Zip Code:15857-1708
Practice Address - Country:US
Practice Address - Phone:814-781-7208
Practice Address - Fax:814-781-8505
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002175-L111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PALE404693Medicare UPIN