Provider Demographics
NPI:1194830497
Name:POLITIS, LEFTERIS (DC)
Entity type:Individual
Prefix:DR
First Name:LEFTERIS
Middle Name:
Last Name:POLITIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 W CRESCENT AVE
Mailing Address - Street 2:STE 2
Mailing Address - City:ALLENDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07401-1532
Mailing Address - Country:US
Mailing Address - Phone:212-671-0677
Mailing Address - Fax:
Practice Address - Street 1:260 W CRESCENT AVE
Practice Address - Street 2:STE 2
Practice Address - City:ALLENDALE
Practice Address - State:NJ
Practice Address - Zip Code:07401-1532
Practice Address - Country:US
Practice Address - Phone:212-671-0677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010543-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor