Provider Demographics
NPI:1780247767
Name:LOBELL, SAMUEL NOAH (DC)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:NOAH
Last Name:LOBELL
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 1:536 W CHESTER ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-1705
Mailing Address - Country:US
Mailing Address - Phone:516-984-2733
Mailing Address - Fax:
Practice Address - Street 1:244 W 54TH ST FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5515
Practice Address - Country:US
Practice Address - Phone:212-262-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-16
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013243111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor