Healthcare Provider Details

I. General information

NPI: 1497755714
Provider Name (Legal Business Name): MICHAEL K. YABLANSKY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 STEWART AVE
BETHPAGE NY
11714-2706
US

IV. Provider business mailing address

541 STEWART AVE
BETHPAGE NY
11714-2706
US

V. Phone/Fax

Practice location:
  • Phone: 516-938-1155
  • Fax: 516-938-1158
Mailing address:
  • Phone: 516-938-1155
  • Fax: 516-938-1158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX005242
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: