Provider Demographics
NPI:1760500151
Name:LEBSON, TODD L (DC)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:L
Last Name:LEBSON
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 1:4 MORRIS CT
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-1825
Mailing Address - Country:US
Mailing Address - Phone:516-802-2476
Mailing Address - Fax:516-433-5396
Practice Address - Street 1:54 SUNNYSIDE BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1517
Practice Address - Country:US
Practice Address - Phone:516-433-5396
Practice Address - Fax:516-433-5386
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008647111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX9A393Medicare ID - Type Unspecified