Provider Demographics
NPI:1154027324
Name:FILBY, SEAN MICHAEL (LACU, LMT)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:MICHAEL
Last Name:FILBY
Suffix:
Gender:M
Credentials:LACU, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 MOUNT SINAI AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766-2356
Mailing Address - Country:US
Mailing Address - Phone:631-603-5696
Mailing Address - Fax:
Practice Address - Street 1:755 MONTAUK HWY STE 1
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:NY
Practice Address - Zip Code:11769-1801
Practice Address - Country:US
Practice Address - Phone:631-603-5696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-31
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007218171100000X
NY029077225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist