Provider Demographics
NPI:1811035009
Name:BECK, LAWRENCE STUART (DC)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:STUART
Last Name:BECK
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 1:999 OLD TOWN RD
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727-1853
Mailing Address - Country:US
Mailing Address - Phone:631-698-6604
Mailing Address - Fax:631-698-1379
Practice Address - Street 1:999 OLD TOWN RD
Practice Address - Street 2:
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727-1853
Practice Address - Country:US
Practice Address - Phone:631-698-6604
Practice Address - Fax:631-698-1379
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX2417111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY226274OtherWORKERS COMPENSATION #
NY226274OtherWORKERS COMPENSATION #