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NPI Code Detail

MEDICARE: MS. LAEL ROYE ATC

MEDICARE: MS. LAEL ROYE ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer070602348NY

General Provider Information

NPI Number : 1871754366
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LAEL ROYE ATC
Provider Business Mailing Address
First Line : 90 NORTHERN BLVD
Second Line :
City : GREENVALE
State : NY
Zip : 11548-1213
Country : US
Telephone Number : 516-626-5080
Fax Number :
Provider Business Practice Location Address
First Line : 90 NORTHERN BLVD
Second Line :
City : GREENVALE
State : NY
Zip : 11548-1213
Country : US
Telephone Number : 516-626-5080
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2008
Last Update Date : 06/18/2008

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