Lacy, Roxane
Lacy, Roxane is an individual health care provider with primary practice located at 45 W Suffolk Ave Fl 2 , Central Islip NY 11722-2156. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Lacy, Roxane can be contacted via phone (631) 582-4858.Contact Information
Primary practice address
45 W Suffolk Ave Fl 2
Central Islip NY 11722-2156
Phone: (631) 582-4858
Fax: (631) 582-4881
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 225654-1 | New York |
Profile Details
| NPI number | 1457402802 |
|---|---|
| LBN Legal business name | Lacy, Roxane |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 14th, 2007 |
| Last updated | Mar 1st, 2013 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457402802 | NPPES |
| New York | MEDICAID | 02554745 |
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