Provider Demographics
NPI:1316330053
Name:LEBIAN INC
Entity type:Organization
Organization Name:LEBIAN INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:518-406-8788
Mailing Address - Street 1:11 SOLAR DR
Mailing Address - Street 2:C
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-3402
Mailing Address - Country:US
Mailing Address - Phone:518-406-8788
Mailing Address - Fax:
Practice Address - Street 1:11 SOLAR DR
Practice Address - Street 2:C
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-3402
Practice Address - Country:US
Practice Address - Phone:518-406-8788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-05
Last Update Date:2015-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026344225700000X
NY024220225700000X
NY024782225700000X
NY012126111N00000X, 111N00000X
NY027800225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty