Provider Demographics
NPI:1821174277
Name:LEMBO, STEPHEN CLEMENT (DC DOCTOR OF CHIROPR)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:CLEMENT
Last Name:LEMBO
Suffix:
Gender:M
Credentials:DC DOCTOR OF CHIROPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3305 JERUSALEM AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-2028
Mailing Address - Country:US
Mailing Address - Phone:516-320-3999
Mailing Address - Fax:
Practice Address - Street 1:3305 JERUSALEM AVE STE 207
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-2028
Practice Address - Country:US
Practice Address - Phone:516-320-3999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-28
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009615111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX4E301Medicare UPIN