Provider Demographics
NPI:1467871202
Name:SCHELL, PETER (LAC)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:SCHELL
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:681 LEXINGTON AVE FL 4
Mailing Address - Street 2:C/0 WERNER CHIROPRACTIC
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2690
Mailing Address - Country:US
Mailing Address - Phone:917-515-8224
Mailing Address - Fax:
Practice Address - Street 1:681 LEXINGTON AVE FL 4
Practice Address - Street 2:C/0 WERNER CHIROPRACTIC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2690
Practice Address - Country:US
Practice Address - Phone:917-515-8224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001977-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY001977-1OtherNEW YORK STATE EDUCATION DEPARTMENT OFFICE OF THE PROFESSIONS