Provider Demographics
NPI:1164998159
Name:LU, HONG REBECCA (LAC)
Entity Type:Individual
Prefix:MISS
First Name:HONG REBECCA
Middle Name:
Last Name:LU
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523-2018
Mailing Address - Country:US
Mailing Address - Phone:917-859-1972
Mailing Address - Fax:
Practice Address - Street 1:405 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-2018
Practice Address - Country:US
Practice Address - Phone:917-859-1972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-17
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003365-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty