Provider Demographics
NPI:1497979538
Name:WHYTE, LORRAINE J (DC)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:J
Last Name:WHYTE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 PALMYRA AVE
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1325
Mailing Address - Country:US
Mailing Address - Phone:516-569-1200
Mailing Address - Fax:516-569-1200
Practice Address - Street 1:122 PALMYRA AVE
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1325
Practice Address - Country:US
Practice Address - Phone:516-569-1200
Practice Address - Fax:516-569-1200
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX003674-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX23101Medicare ID - Type Unspecified