Provider Demographics
NPI:1477622611
Name:ASLAN, STACY (DC)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:ASLAN
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 1:146 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2150
Mailing Address - Country:US
Mailing Address - Phone:631-549-1490
Mailing Address - Fax:631-673-7249
Practice Address - Street 1:146 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2150
Practice Address - Country:US
Practice Address - Phone:631-549-1490
Practice Address - Fax:631-673-7249
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005931111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX36811Medicare ID - Type UnspecifiedEMPIRE