Healthcare Provider Details

I. General information

NPI: 1760500151
Provider Name (Legal Business Name): TODD L LEBSON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 02/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 SUNNYSIDE BLVD SUITE B
PLAINVIEW NY
11803-1517
US

IV. Provider business mailing address

4 MORRIS CT
SYOSSET NY
11791-1825
US

V. Phone/Fax

Practice location:
  • Phone: 516-433-5396
  • Fax: 516-433-5386
Mailing address:
  • Phone: 516-802-2476
  • Fax: 516-433-5396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX008647
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: