Berlin, Lance R

Berlin, Lance R is an individual health care provider with primary practice located at 2330 Union Blvd , Islip NY 11751-3103. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Berlin, Lance R can be contacted via phone (631) 277-8900.

Contact Information

Primary practice address
2330 Union Blvd Islip NY 11751-3103
Phone: (631) 277-8900
Fax: (631) 277-0298
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X N004704-1 New York

Profile Details

NPI number 1942262241
LBN Legal business name Berlin, Lance R
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942262241 NPPES
New York MEDICAID 01290248

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