Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | X007901 | NY |
NPI | 1003931718 |
---|---|
Provider Name | Dr. Onisis Louca |
First Address | North Bellmore, NY 11710-5551 |
Second Address | North Bellmore, NY 11710-5551 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 11/06/2008 |