Provider Demographics
NPI:1013047182
Name:LAVELLE, DENNIS (DC)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:
Last Name:LAVELLE
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 1:540 N STATE RD
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1598
Mailing Address - Country:US
Mailing Address - Phone:914-923-4545
Mailing Address - Fax:
Practice Address - Street 1:540 N STATE RD
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-1598
Practice Address - Country:US
Practice Address - Phone:914-923-4545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009321-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX9B191Medicare ID - Type Unspecified