Provider Demographics
NPI:1437145703
Name:LENTINI, PAUL MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:MICHAEL
Last Name:LENTINI
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 1:28 BARDONIA RD
Mailing Address - Street 2:
Mailing Address - City:BARDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:10954-2123
Mailing Address - Country:US
Mailing Address - Phone:845-623-1558
Mailing Address - Fax:845-623-6437
Practice Address - Street 1:28 BARDONIA RD
Practice Address - Street 2:
Practice Address - City:BARDONIA
Practice Address - State:NY
Practice Address - Zip Code:10954-2123
Practice Address - Country:US
Practice Address - Phone:845-623-1558
Practice Address - Fax:845-623-6437
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX07536111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
X6590XGNG1Medicare PIN
NYX65901Medicare UPIN