| Stephen Pruden Dc Llc | |
|
55 Bryant Ave, 2nd Floor, Roslyn, NY 11576-1137 | |
| (516) 626-3965 | |
| (516) 625-7701 |
| Full Name | Stephen Pruden Dc Llc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 55 Bryant Ave, Roslyn, New York |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215032719 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | X004234-1 (New York) | Primary |
| Provider Name | Stephen J Pruden |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1144236019 PECOS PAC ID: 6204842339 Enrollment ID: I20060228000187 |
| Mailing Address | Practice Location Address |
|---|---|
| Stephen Pruden Dc Llc 55 Bryant Ave, 2nd Floor, Roslyn, NY 11576-1137 Ph: (516) 626-3965 | Stephen Pruden Dc Llc 55 Bryant Ave, 2nd Floor, Roslyn, NY 11576-1137 Ph: (516) 626-3965 |
Dr. Stephen Joseph Pruden, DC Chiropractor Medicare: May Accept Medicare Assignments Practice Location: 55 Bryant Ave, 2nd Floor, Roslyn, NY 11576 Phone: 516-626-3965 Fax: 516-625-7701 | |
Dr. Patrick G Decarolis, Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 30 Middle Neck Rd, Roslyn, NY 11576 Phone: 516-365-2700 Fax: 516-365-2794 |