Healthcare Provider Details

I. General information

NPI: 1740351964
Provider Name (Legal Business Name): LAMBOY CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 04/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 CONKLIN ST
FARMINGDALE NY
11735-2608
US

IV. Provider business mailing address

245 CONKLIN ST
FARMINGDALE NY
11735-2608
US

V. Phone/Fax

Practice location:
  • Phone: 516-249-4488
  • Fax: 516-249-4488
Mailing address:
  • Phone: 516-249-4488
  • Fax: 516-249-4488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License NumberX010041-1
License Number StateNM

VIII. Authorized Official

Name: DR. RUSSELL M LAMBOY
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 516-249-4488