Provider Demographics
NPI:1003139437
Name:TEICH, AARON JASON (LAC)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:JASON
Last Name:TEICH
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 W 84TH ST
Mailing Address - Street 2:APT. 2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-4738
Mailing Address - Country:US
Mailing Address - Phone:917-445-7232
Mailing Address - Fax:
Practice Address - Street 1:7 W 84TH ST
Practice Address - Street 2:APT. 2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-4738
Practice Address - Country:US
Practice Address - Phone:917-445-7232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-12
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0042581171100000X
CAAC12699171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist