Provider Demographics
NPI:1376080937
Name:LORRAINE PARKER DC PLLC
Entity Type:Organization
Organization Name:LORRAINE PARKER DC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:JILL
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:914-248-5122
Mailing Address - Street 1:361 ROUTE 202
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:NY
Mailing Address - Zip Code:10589-3246
Mailing Address - Country:US
Mailing Address - Phone:914-248-5122
Mailing Address - Fax:914-248-5125
Practice Address - Street 1:361 ROUTE 202
Practice Address - Street 2:
Practice Address - City:SOMERS
Practice Address - State:NY
Practice Address - Zip Code:10589-3246
Practice Address - Country:US
Practice Address - Phone:914-248-5122
Practice Address - Fax:914-248-5125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-20
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX003379-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP415014OtherOXFORD
NY324333OtherUNITED
NY4323407OtherAETNA
NYX18571Medicare PIN