Provider Demographics
NPI:1316269970
Name:LEWANDOWSKI FAMILY CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:LEWANDOWSKI FAMILY CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:LEWANDOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-396-7388
Mailing Address - Street 1:1125 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-4508
Mailing Address - Country:US
Mailing Address - Phone:215-396-7388
Mailing Address - Fax:215-396-7390
Practice Address - Street 1:1125 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-4508
Practice Address - Country:US
Practice Address - Phone:215-396-7388
Practice Address - Fax:215-396-7390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-005610-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2355735000OtherINDEPENDENCE BLUE CROSS