Healthcare Provider Details

I. General information

NPI: 1831590348
Provider Name (Legal Business Name): DR. PETER D LICHTENSTEIN D.C., L.AC., PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2014
Last Update Date: 09/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 PROSPECT ST
NEW PALTZ NY
12561-1137
US

IV. Provider business mailing address

7 PROSPECT ST
NEW PALTZ NY
12561-1137
US

V. Phone/Fax

Practice location:
  • Phone: 845-256-0212
  • Fax: 845-255-9192
Mailing address:
  • Phone: 845-256-0212
  • Fax: 845-255-9192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX-007174-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberX-007174-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberX-007174-1
License Number StateNY

VIII. Authorized Official

Name: DR. PETER D LICHTENSTEIN
Title or Position: CHIROPRACTOR/ACUPUNCTURIST
Credential: D.C, L.AC
Phone: 845-256-0212