Fabio-bento Sequeira, | |
483 10th Ave Rm 525, New York, NY 10018-9824 | |
(516) 244-6686 | |
Not Available |
Full Name | Fabio-bento Sequeira |
---|---|
Gender | Male |
Speciality | Chiropractor |
Location | 483 10th Ave Rm 525, New York, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1538946231 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | X013750-01 (New York) | Primary |
Provider Name | Lifetime Physical Therapy And Chiropractic Rehabilitation Pllc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1821453572 PECOS PAC ID: 3971807025 Enrollment ID: O20160210000469 |
Mailing Address | Practice Location Address |
---|---|
Fabio-bento Sequeira, 286 Park Ter N, East Meadow, NY 11554-3510 Ph: (516) 244-6686 | Fabio-bento Sequeira, 483 10th Ave Rm 525, New York, NY 10018-9824 Ph: (516) 244-6686 |
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