Provider Demographics
NPI:1689937070
Name:LORD, STEPHANIE (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:LORD
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 1:31 PURCHASE ST
Mailing Address - Street 2:SUITE 2-3
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-3013
Mailing Address - Country:US
Mailing Address - Phone:914-409-8385
Mailing Address - Fax:
Practice Address - Street 1:31 PURCHASE ST
Practice Address - Street 2:SUITE 2-3
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-3013
Practice Address - Country:US
Practice Address - Phone:914-409-8385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX012102111N00000X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition