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Contact Information

CHAMPION PROFESSIONAL SERVICES
93 TALLMADGE TRL
MILLER PLACE, NY11764-2327
 Phone: 631-828-4373
 Fax: 631-828-4373
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatrics

2251G0304X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for CHAMPION PROFESSIONAL SERVICES

NPI # 1487998183
LBN Legal business name CHAMPION PROFESSIONAL SERVICES
Authorized official MICHAEL LYONS - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 11/19/2012
Last updated 11/19/2012 - About 14 years ago
Identifiers
NY License # 18775
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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