Provider Demographics
NPI:1851704944
Name:DR. PETER D LICHTENSTEIN D.C., L.AC., PC
Entity Type:Organization
Organization Name:DR. PETER D LICHTENSTEIN D.C., L.AC., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:D
Authorized Official - Last Name:LICHTENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LAC
Authorized Official - Phone:845-256-0212
Mailing Address - Street 1:7 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-1137
Mailing Address - Country:US
Mailing Address - Phone:845-256-0212
Mailing Address - Fax:845-255-9192
Practice Address - Street 1:7 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-1137
Practice Address - Country:US
Practice Address - Phone:845-256-0212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX-007174-1111N00000X, 111NS0005X
NY000457-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty