Provider Demographics
NPI:1750466686
Name:LONSTEIN, HERBERT M (DC, LAC)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:M
Last Name:LONSTEIN
Suffix:
Gender:M
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 TERRACE HILL
Mailing Address - Street 2:P.O. BOX 466
Mailing Address - City:ELLENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12428
Mailing Address - Country:US
Mailing Address - Phone:845-647-8866
Mailing Address - Fax:845-647-8867
Practice Address - Street 1:1 TERRACE HILL
Practice Address - Street 2:
Practice Address - City:ELLENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12428
Practice Address - Country:US
Practice Address - Phone:845-647-8866
Practice Address - Fax:845-647-8867
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX003928-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX20941Medicare PIN