Provider Demographics
NPI:1912220302
Name:LITWIN, DANIEL SACKS (LAC, LMT)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:SACKS
Last Name:LITWIN
Suffix:
Gender:M
Credentials:LAC, LMT
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6 BANK ST
Mailing Address - Street 2:
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-1620
Mailing Address - Country:US
Mailing Address - Phone:631-560-1453
Mailing Address - Fax:
Practice Address - Street 1:2 BERARD BLVD
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:NY
Practice Address - Zip Code:11769
Practice Address - Country:US
Practice Address - Phone:631-589-4183
Practice Address - Fax:631-589-3619
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-12
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY05662171100000X
NY022926225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist