Provider Demographics
NPI:1912130345
Name:LOCKEY, ROBERT (DC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:LOCKEY
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 1:255 EASTERN PARKWAY
Mailing Address - Street 2:LOEWER LEVEL(BASEMENT)
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238
Mailing Address - Country:US
Mailing Address - Phone:718-636-8291
Mailing Address - Fax:718-636-8667
Practice Address - Street 1:255 EASTERN PKWY
Practice Address - Street 2:LOEWER LEVEL(BASEMENT)
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-6300
Practice Address - Country:US
Practice Address - Phone:718-636-8291
Practice Address - Fax:718-636-8667
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006142111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner